Kylie Gould

Individual provider Active NPI Behavior Analyst · Pass Christian, MS

NPI 1679938476 · NPPES record last updated Dec 8, 2021

Key facts

NPI
1679938476
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
1-12-55728
Practice address
11006 Edwin Ladner Rd
Pass Christian, MS 39571-9366
Phone
(601) 590-3283
NPI assigned
Dec 21, 2015
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Perfect Child LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-12-55728 Yes

Addresses

Primary practice location

11006 Edwin Ladner Rd
Pass Christian, MS 39571-9366

Mailing address

1325 W Causeway Approach
Mandeville, LA 70471-3043

Other providers in Pass Christian, MS

All providers in Pass Christian, MS · Behavior Analyst in Mississippi

Sources for this page

Verify at the official NPI Registry.