Provider Demographics
NPI:1144947193
Name:KINSEY, JIRITA NATE' (BCBA)
Entity type:Individual
Prefix:
First Name:JIRITA
Middle Name:NATE'
Last Name:KINSEY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:JIRITA
Other - Middle Name:
Other - Last Name:ATKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:309 S OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65301-4431
Mailing Address - Country:US
Mailing Address - Phone:314-239-8305
Mailing Address - Fax:
Practice Address - Street 1:309 S OHIO AVE
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301-4431
Practice Address - Country:US
Practice Address - Phone:888-515-1793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-20
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022020922103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst