Provider Demographics
NPI:1225509086
Name:MORIARTY, KATHERINE (BCBA)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:MORIARTY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 FM 1488 RD APT 846
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4295
Mailing Address - Country:US
Mailing Address - Phone:717-398-8282
Mailing Address - Fax:
Practice Address - Street 1:9297 WAHRENBERGER RD
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2441
Practice Address - Country:US
Practice Address - Phone:936-788-7770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst