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NPI Code Detail

MEDICARE: MS. KENESHA D CURTIS M.A. BCBA

MEDICARE: MS. KENESHA D CURTIS M.A. 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 Analyst1-10-7462NJ

General Provider Information

NPI Number : 1700155710
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KENESHA D CURTIS M.A. BCBA
Provider Business Mailing Address
First Line : 3500 DEPAUW BLVD STE 3070
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-6135
Country : US
Telephone Number : 855-324-0885
Fax Number : 732-640-0043
Provider Business Practice Location Address
First Line : 4000 SMITHTOWN RD STE 200
Second Line :
City : SUWANEE
State : GA
Zip : 30024-6560
Country : US
Telephone Number : 470-632-4990
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2011
Last Update Date : 08/04/2021

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