Jonathan Kimball, BCBA-D
Individual provider Active NPI Behavior Analyst · Georgetown, ME
NPI 1801212386 · NPPES record last updated Aug 22, 2014
Key facts
- NPI
- 1801212386
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- Practice address
- 35 Ridge Rd
Georgetown, ME 04548-3245 - Phone
- (207) 449-9169
- NPI assigned
- Mar 8, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Yes |
Addresses
Primary practice location
35 Ridge Rd
Georgetown, ME 04548-3245
Mailing address
35 Ridge Rd
Georgetown, ME 04548-3245
Phone (207) 449-9169
Other providers in Georgetown, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.