Provider Demographics
NPI:1033352844
Name:FLYNN, KERRI E (MA, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:KERRI
Middle Name:E
Last Name:FLYNN
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:KERRI
Other - Middle Name:
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:609 BROAD RIVER RD APT 4404
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29588-7499
Mailing Address - Country:US
Mailing Address - Phone:845-656-7306
Mailing Address - Fax:
Practice Address - Street 1:609 BROAD RIVER RD
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-7499
Practice Address - Country:US
Practice Address - Phone:845-656-7306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-08
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst