Individual
TANEA L KINKEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., BCBA, LBA
Contact information
Practice address
430 S 7TH ST, VANDALIA, IL 62471-2734
(618) 339-1063
Mailing address
430 S 7TH ST, VANDALIA, IL 62471-2734
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-56513
—
103K00000X
Behavior Analyst
152.001085
IL
103K00000X
Behavior Analyst
2017005989
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017005989
LBA
MO
Enumeration date
11/08/2018
Last updated
07/14/2026
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