Provider Demographics
NPI:1407126451
Name:KANTER, ANN AXTELL (BA, BCABA)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:AXTELL
Last Name:KANTER
Suffix:
Gender:F
Credentials:BA, BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 STONE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-5038
Mailing Address - Country:US
Mailing Address - Phone:607-273-7489
Mailing Address - Fax:
Practice Address - Street 1:7 STONE CREEK DR
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-5038
Practice Address - Country:US
Practice Address - Phone:607-273-7489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst