Provider Demographics
NPI:1528448669
Name:KESLER, KAITLIN (BCBA)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:KESLER
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 1:8100 M4 WYOMING BLVD STE 406
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1861
Mailing Address - Country:US
Mailing Address - Phone:505-828-3837
Mailing Address - Fax:877-828-3837
Practice Address - Street 1:1817 WELLSPRING AVE SE STE D
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-4956
Practice Address - Country:US
Practice Address - Phone:505-828-3837
Practice Address - Fax:877-828-1550
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-03
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor