Provider Demographics
NPI:1851887681
Name:KIRBY, BEVERLY L (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:L
Last Name:KIRBY
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 1:8461 WINDING TRL
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-1435
Mailing Address - Country:US
Mailing Address - Phone:301-219-8190
Mailing Address - Fax:
Practice Address - Street 1:8461 WINDING TRL
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724-1435
Practice Address - Country:US
Practice Address - Phone:301-219-8190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-04
Last Update Date:2018-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst