Provider Demographics
NPI:1841885993
Name:KERR, LIDIANE M (BCBA)
Entity type:Individual
Prefix:
First Name:LIDIANE
Middle Name:M
Last Name:KERR
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 PRYOR LN
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-1656
Mailing Address - Country:US
Mailing Address - Phone:406-860-1480
Mailing Address - Fax:406-552-1482
Practice Address - Street 1:801 15TH ST W LOWR
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-4175
Practice Address - Country:US
Practice Address - Phone:406-901-5000
Practice Address - Fax:406-552-1482
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-01
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPSY-BA-LIC-3652103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst