Individual
KATELYN KIDNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, LABA
Contact information
Practice address
461 RIVER RD, ANDOVER, MA 01810-4349
(978) 654-4300
Mailing address
38 ATKINSON ST, LYNN, MA 01905-1103
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
3655-MH-B1
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3655-MH-B1
BOARD OF ALLIED MENTAL HEALTH AND HUMAN SERVICE PROFESSIONALS
MA
Enumeration date
08/30/2021
Last updated
08/30/2021
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