Provider Demographics
NPI:1982181400
Name:GILBERT, KIRSTEN (BCBA)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:GILBERT
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 1:180 NAUGHER RD
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35811-9060
Mailing Address - Country:US
Mailing Address - Phone:256-882-2457
Mailing Address - Fax:256-882-2459
Practice Address - Street 1:306 WYNN DR NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35805-1961
Practice Address - Country:US
Practice Address - Phone:256-882-2457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-26
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-21-53079OtherBACB BOARD