Provider Demographics
NPI:1356933956
Name:KENNEDY, CHRISTIN HOPE (BS, BCABA)
Entity type:Individual
Prefix:
First Name:CHRISTIN
Middle Name:HOPE
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:BS, BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 BLAIRWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-2371
Mailing Address - Country:US
Mailing Address - Phone:864-529-1573
Mailing Address - Fax:
Practice Address - Street 1:200 ELFORD CT
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29306-3250
Practice Address - Country:US
Practice Address - Phone:864-529-1573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst