Provider Demographics
NPI:1649842196
Name:LINDEN, KELLEY (MED, BCBA)
Entity type:Individual
Prefix:
First Name:KELLEY
Middle Name:
Last Name:LINDEN
Suffix:
Gender:F
Credentials:MED, 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 1117
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-0965
Mailing Address - Country:US
Mailing Address - Phone:401-829-3088
Mailing Address - Fax:
Practice Address - Street 1:324 SHIPPEETOWN RD
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1118
Practice Address - Country:US
Practice Address - Phone:401-213-3302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst