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General NPI Number Information
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NPI Number | 1972199669
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Entity Type | Individual
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Provider Name | KENDALL MALFAVON M.S., BCBA, LBA
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Gender | Female
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Dates
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Enumeration Date | 12/16/2020
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 640 GRASSMERE PARK STE 116
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City | NASHVILLE
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State | TN
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Zip | 37211-3678
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Country | US
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Telephone | 629-236-4547
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Fax |
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Provider Business Mailing Address
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Address Line | 306 N KENSINGTON AVE
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City | LA GRANGE PARK
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State | IL
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Zip | 60526-1870
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Country | US
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Telephone |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State | TN
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