Provider Demographics
NPI:1134570849
Name:CONNER, MOLLY (BCBA)
Entity type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:
Last Name:CONNER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MISS
Other - First Name:MOLLY
Other - Middle Name:
Other - Last Name:SYLVESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:9905 WAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-3402
Mailing Address - Country:US
Mailing Address - Phone:913-634-0701
Mailing Address - Fax:
Practice Address - Street 1:6394 COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1506
Practice Address - Country:US
Practice Address - Phone:800-345-0448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
KS234103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst