Provider Demographics
NPI:1073120747
Name:HURD, KAYLEY (BCBA LBA)
Entity Type:Individual
Prefix:
First Name:KAYLEY
Middle Name:
Last Name:HURD
Suffix:
Gender:F
Credentials:BCBA LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 MORRISON SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-3401
Mailing Address - Country:US
Mailing Address - Phone:423-802-1982
Mailing Address - Fax:423-320-3913
Practice Address - Street 1:625 MORRISON SPRINGS RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37415-3401
Practice Address - Country:US
Practice Address - Phone:423-802-1982
Practice Address - Fax:423-320-3913
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1479103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
RBT-20-133896OtherREGISTERED BEHAVIOR TECHNICIAN