Provider Demographics
NPI:1386400885
Name:PERDUE, KRISTIN (MED, BCBA, LABA)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:PERDUE
Suffix:
Gender:F
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 1:39 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LUNENBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01462-1428
Mailing Address - Country:US
Mailing Address - Phone:978-790-5793
Mailing Address - Fax:
Practice Address - Street 1:39 MAIN ST
Practice Address - Street 2:
Practice Address - City:LUNENBURG
Practice Address - State:MA
Practice Address - Zip Code:01462-1428
Practice Address - Country:US
Practice Address - Phone:978-790-5793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst