Provider Demographics
NPI:1396400016
Name:KIMBERLY KNECHT LICENSED BEHAVIOR ANALYST, PLLC
Entity Type:Organization
Organization Name:KIMBERLY KNECHT LICENSED BEHAVIOR ANALYST, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:KNECHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-219-4839
Mailing Address - Street 1:605 LINE RD
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-1202
Mailing Address - Country:US
Mailing Address - Phone:134-721-9483
Mailing Address - Fax:
Practice Address - Street 1:605 LINE RD
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-1202
Practice Address - Country:US
Practice Address - Phone:472-194-8393
Practice Address - Fax:347-412-6028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty