Provider Demographics
NPI:1588156822
Name:HYDE, KAMRYN (RBT)
Entity type:Individual
Prefix:
First Name:KAMRYN
Middle Name:
Last Name:HYDE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2795 N SPEER BLVD # A328
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-4270
Mailing Address - Country:US
Mailing Address - Phone:937-414-2591
Mailing Address - Fax:
Practice Address - Street 1:2795 N SPEER BLVD # A328
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-4270
Practice Address - Country:US
Practice Address - Phone:937-414-2591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-02
Last Update Date:2018-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18-56524106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician