Provider Demographics
NPI:1043547201
Name:VEGA, CATHERINE (MS BCBA)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:
Last Name:VEGA
Suffix:
Gender:F
Credentials:MS BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9011 NW 7TH CT
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6451
Mailing Address - Country:US
Mailing Address - Phone:954-394-4883
Mailing Address - Fax:954-241-6872
Practice Address - Street 1:9011 NW 7TH CT
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6451
Practice Address - Country:US
Practice Address - Phone:954-394-4883
Practice Address - Fax:954-241-6872
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-09
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS00586103K00000X
MO2023008346103K00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst