Provider Demographics
NPI:1588237093
Name:SUTER, KIMBERLY ANN (MA, BCBA, CBIS, LBA)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:SUTER
Suffix:
Gender:F
Credentials:MA, BCBA, CBIS, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18366 W 157TH TER
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-7065
Mailing Address - Country:US
Mailing Address - Phone:918-313-1931
Mailing Address - Fax:
Practice Address - Street 1:18366 W 157TH TER
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-7065
Practice Address - Country:US
Practice Address - Phone:918-313-1931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-22
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019018723103K00000X
KSLBA214103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst