| NPI | 1255969663 | 
|---|---|
| Former Name | STEPHANIE KIMMEN | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: DE 1-20-46327) | 
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-20-46327) | 
| 106S00000X Behavior Technician (Licence: CO RBT.17.41116) | |
| Enumeration Date | 2020-03-31 | 
| Last Update Date | 2025-06-10 |