Provider Demographics
NPI:1346654647
Name:HORTON, KATHRYN GUENEVERE (BCBA)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:GUENEVERE
Last Name:HORTON
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 1:5951 DUGOUT TER
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-4570
Mailing Address - Country:US
Mailing Address - Phone:800-299-5230
Mailing Address - Fax:
Practice Address - Street 1:5951 DUGOUT TER
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-4570
Practice Address - Country:US
Practice Address - Phone:800-299-5230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-13
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No251C00000XAgenciesDay Training, Developmentally Disabled Services