Provider Demographics
NPI:1598901134
Name:KIDD, ROBERT F (BCBA)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:F
Last Name:KIDD
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ANNAWAMSCUTT RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-1916
Mailing Address - Country:US
Mailing Address - Phone:401-241-2563
Mailing Address - Fax:
Practice Address - Street 1:8 ANNAWAMSCUTT RD
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-1916
Practice Address - Country:US
Practice Address - Phone:401-241-2563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-04
Last Update Date:2009-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst