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NPI Code Detail

MEDICARE: LIDIANE M KERR BCBA

MEDICARE: LIDIANE M KERR 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
1103K00000XBehavior AnalystPSY-BA-LIC-3652MT

General Provider Information

NPI Number : 1841885993
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIDIANE M KERR BCBA
Provider Business Mailing Address
First Line : 2040 PRYOR LN
Second Line :
City : BILLINGS
State : MT
Zip : 59102-1656
Country : US
Telephone Number : 406-860-1480
Fax Number : 406-552-1482
Provider Business Practice Location Address
First Line : 801 15TH ST W LOWR
Second Line :
City : BILLINGS
State : MT
Zip : 59102-4175
Country : US
Telephone Number : 406-901-5000
Fax Number : 406-552-1482
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2021
Last Update Date : 05/23/2024

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