Provider Demographics
NPI:1477923365
Name:LORING, KATHLEEN ELIZABETH (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:ELIZABETH
Last Name:LORING
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:ELIZABETH
Other - Last Name:HODSKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:709 GULLIVER ST
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN INN
Mailing Address - State:SC
Mailing Address - Zip Code:29644-2216
Mailing Address - Country:US
Mailing Address - Phone:858-585-6143
Mailing Address - Fax:
Practice Address - Street 1:709 GULLIVER ST
Practice Address - Street 2:
Practice Address - City:FOUNTAIN INN
Practice Address - State:SC
Practice Address - Zip Code:29644-2216
Practice Address - Country:US
Practice Address - Phone:618-741-1066
Practice Address - Fax:858-251-8895
Is Sole Proprietor?:No
Enumeration Date:2015-10-05
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-15-19858103K00000X
CO1-15-19858103K00000X
MDLBA336103K00000X
SC1-15-19858103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst