Provider Demographics
NPI:1265617294
Name:PERRIN, NANETTE LEA (MA, BCBA)
Entity type:Individual
Prefix:
First Name:NANETTE
Middle Name:LEA
Last Name:PERRIN
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 S BRENTWOOD ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-4908
Mailing Address - Country:US
Mailing Address - Phone:913-948-2732
Mailing Address - Fax:
Practice Address - Street 1:801 S BRENTWOOD ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-4908
Practice Address - Country:US
Practice Address - Phone:913-948-2732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2011-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
KSBCBA 1-01-0654103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No171M00000XOther Service ProvidersCase Manager/Care Coordinator