Provider Demographics
NPI:1063183051
Name:ALFONSO, KIRSTIN (MED, BCBA, LABA)
Entity type:Individual
Prefix:
First Name:KIRSTIN
Middle Name:
Last Name:ALFONSO
Suffix:
Gender:
Credentials:MED, BCBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BATEMAN ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01832-2537
Mailing Address - Country:US
Mailing Address - Phone:978-204-0148
Mailing Address - Fax:
Practice Address - Street 1:6 BATEMAN ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01832-2537
Practice Address - Country:US
Practice Address - Phone:978-204-0148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2025-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst