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NPI Code Detail

MEDICARE: KENDRA KITCHEN BCBA

MEDICARE: KENDRA KITCHEN BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-12-12515FL
2103K00000XBehavior Analyst1-12-12515

General Provider Information

NPI Number : 1033464862
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENDRA KITCHEN BCBA
Provider Business Mailing Address
First Line : 8181 COMMERCE PARK DR STE 726
Second Line :
City : HOUSTON
State : TX
Zip : 77036-7449
Country : US
Telephone Number : 346-217-8328
Fax Number :
Provider Business Practice Location Address
First Line : 8181 COMMERCE PARK DR STE 726
Second Line :
City : HOUSTON
State : TX
Zip : 77036-7449
Country : US
Telephone Number : 346-217-8328
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2012
Last Update Date : 12/26/2021

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