Provider Demographics
NPI:1841437811
Name:PEELE, KIMAHNI (BCBA)
Entity type:Individual
Prefix:
First Name:KIMAHNI
Middle Name:
Last Name:PEELE
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 EBBING CT
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:MD
Mailing Address - Zip Code:21221-2900
Mailing Address - Country:US
Mailing Address - Phone:443-691-5733
Mailing Address - Fax:
Practice Address - Street 1:8 EBBING CT
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MD
Practice Address - Zip Code:21221-2900
Practice Address - Country:US
Practice Address - Phone:443-691-5733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1-08-4729103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst