Healthcare Provider Details

I. General information

NPI: 1932045408
Provider Name (Legal Business Name): KAIDENCE HARRIS RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

592 KY 15 S STE 7
CAMPTON KY
41301-9552
US

IV. Provider business mailing address

PO BOX 103
WEST LIBERTY KY
41472-0103
US

V. Phone/Fax

Practice location:
  • Phone: 606-668-7393
  • Fax:
Mailing address:
  • Phone: 606-689-2042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: