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General NPI Number Information
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NPI Number | 1265196679
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Entity Type | Individual
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Provider Name | REBECCA CHARLENE KIND
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Gender | Female
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Dates
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Enumeration Date | 10/22/2021
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 10400 N BAEHR RD
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City | MEQUON
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State | WI
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Zip | 53092-4472
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Country | US
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Telephone | 833-646-3222
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Fax |
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Provider Business Mailing Address
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Address Line | 4918 SELL ST
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City | HARTFORD
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State | WI
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Zip | 53027-9425
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Country | US
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Telephone | 872-236-3794
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | J232-7239-7958
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License Number State | IL
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