Healthcare Provider Details

I. General information

NPI: 1710626346
Provider Name (Legal Business Name): KIMBERLY ANN FRIAS BCBA, LABA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMBERLY ANN GUERRIERO

II. Dates (important events)

Enumeration Date: 06/01/2022
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 ERDMAN WAY STE 300
LEOMINSTER MA
01453-1818
US

IV. Provider business mailing address

300 E MAIN ST STE 200
MILFORD MA
01757-2806
US

V. Phone/Fax

Practice location:
  • Phone: 508-478-0207
  • Fax: 508-634-6984
Mailing address:
  • Phone: 508-478-0207
  • Fax: 508-634-6984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLABA10002279
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: