Provider Demographics
NPI:1184782153
Name:FRANTZ, KIMBERLY SUE (BCBA)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:SUE
Last Name:FRANTZ
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:PO BOX 13877
Mailing Address - Street 2:
Mailing Address - City:MEXICO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32410-3877
Mailing Address - Country:US
Mailing Address - Phone:850-532-9330
Mailing Address - Fax:
Practice Address - Street 1:209 VIRGINIA DR
Practice Address - Street 2:
Practice Address - City:MEXICO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32456-0143
Practice Address - Country:US
Practice Address - Phone:850-532-9330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral