Provider Demographics
NPI:1376810309
Name:FLINT, KIMBERLY MARIAH (BCBA, LABA)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:MARIAH
Last Name:FLINT
Suffix:
Gender:F
Credentials:BCBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:LUNENBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01462-2037
Mailing Address - Country:US
Mailing Address - Phone:978-602-0550
Mailing Address - Fax:
Practice Address - Street 1:31 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:LUNENBURG
Practice Address - State:MA
Practice Address - Zip Code:01462-2037
Practice Address - Country:US
Practice Address - Phone:978-602-0550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-18
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-11-9451103K00000X
MA97103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst