Healthcare Provider Details

I. General information

NPI: 1518520378
Provider Name (Legal Business Name): KENDRA ANN CAHILL MS, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2019
Last Update Date: 04/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 ROUTE 101 STE 11
BEDFORD NH
03110-5031
US

IV. Provider business mailing address

360 ROUTE 101 STE 11
BEDFORD NH
03110-5031
US

V. Phone/Fax

Practice location:
  • Phone: 603-471-2522
  • Fax:
Mailing address:
  • Phone: 603-471-2522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-19-34424
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: