Provider Demographics
NPI:1073921797
Name:BAYNES, KATHERINE MOLETA
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:MOLETA
Last Name:BAYNES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 ELM ST
Mailing Address - Street 2:
Mailing Address - City:COTUIT
Mailing Address - State:MA
Mailing Address - Zip Code:02635-3506
Mailing Address - Country:US
Mailing Address - Phone:508-274-2480
Mailing Address - Fax:
Practice Address - Street 1:14 ELM ST
Practice Address - Street 2:
Practice Address - City:COTUIT
Practice Address - State:MA
Practice Address - Zip Code:02635-3506
Practice Address - Country:US
Practice Address - Phone:508-274-2480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-25
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst