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Individual

AMANDA LYNN MCKIERNAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
963 SCARSDALE RD, SCARSDALE, NY 10583-4852
(914) 810-2237
Mailing address
105 GARTH RD APT 6G, SCARSDALE, NY 10583-3741
(914) 774-7362

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
001555
NY
103K00000X
Behavior Analyst
Primary
1-17-26351
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001555
LICENSED BEHAVIOR ANALYST
NY
Enumeration date
07/07/2017
Last updated
07/03/2020
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