Provider Demographics
NPI:1205127370
Name:POTTER, KIMBERLY M (BCBA LBA LBS)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:M
Last Name:POTTER
Suffix:
Gender:F
Credentials:BCBA LBA LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4631
Mailing Address - Country:US
Mailing Address - Phone:201-978-3815
Mailing Address - Fax:
Practice Address - Street 1:325 N SAINT PAUL ST STE 3100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-3923
Practice Address - Country:US
Practice Address - Phone:888-320-3222
Practice Address - Fax:347-402-2106
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1084116103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst