Individual
KIMBERLY T ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LABA, LMHC
Contact information
Practice address
100 CUMMINGS CTR STE 135H, BEVERLY, MA 01915-6127
(978) 927-0172
Mailing address
100 CUMMINGS CTR, SUITE 135H, BEVERLY, MA 01915-6127
(978) 927-0172
(978) 927-0179
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
996
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
996
LABA LICENSE
MA
Enumeration date
05/09/2018
Last updated
05/09/2018
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