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NPI Code Detail

MEDICARE: KYNDA EDEN BCBA

MEDICARE: KYNDA EDEN BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-20-136885AZ
2103K00000XBehavior AnalystBEH-001026AZ

General Provider Information

NPI Number : 1811590896
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYNDA EDEN BCBA
Provider Business Mailing Address
First Line : 2146 W HIGHLAND AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85015-4147
Country : US
Telephone Number : 619-822-9721
Fax Number :
Provider Business Practice Location Address
First Line : 2146 W HIGHLAND AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85015-4147
Country : US
Telephone Number : 619-822-9721
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2020
Last Update Date : 02/13/2024

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Directions to “ KYNDA EDEN BCBA” Practice Location

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