Provider Demographics
NPI:1598032500
Name:KINNEBREW, ERICA ELIZABETH (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:ELIZABETH
Last Name:KINNEBREW
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ALDER RD APT B
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21402-1012
Mailing Address - Country:US
Mailing Address - Phone:888-958-5753
Mailing Address - Fax:888-958-5753
Practice Address - Street 1:12290 REGAL LILY LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7249
Practice Address - Country:US
Practice Address - Phone:850-932-8021
Practice Address - Fax:800-973-3660
Is Sole Proprietor?:No
Enumeration Date:2011-11-18
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst