Provider Demographics
NPI:1457961781
Name:KEARNS, AMY LEE (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LEE
Last Name:KEARNS
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 NORMAN DR
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-2615
Mailing Address - Country:US
Mailing Address - Phone:551-579-7220
Mailing Address - Fax:
Practice Address - Street 1:274 NORMAN DR
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-2615
Practice Address - Country:US
Practice Address - Phone:551-579-7220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-02
Last Update Date:2020-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst