Provider Demographics
NPI:1841686300
Name:KAHLER, SUSANNE ANNCHEN (BCBA)
Entity type:Individual
Prefix:
First Name:SUSANNE
Middle Name:ANNCHEN
Last Name:KAHLER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:ANN
Other - Last Name:TANORI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:2501 W 26TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105
Mailing Address - Country:US
Mailing Address - Phone:605-444-9800
Mailing Address - Fax:
Practice Address - Street 1:704 JUSTUS AVE UNIT 1
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:SD
Practice Address - Zip Code:57032-8276
Practice Address - Country:US
Practice Address - Phone:605-988-8332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-11
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-15-18273103G00000X
AK9103K00000X
AK1-15-18723103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1841686300OtherNPI