Provider Demographics
NPI:1538518626
Name:HATCH, KYLIE (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:KYLIE
Middle Name:
Last Name:HATCH
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:KYLIE
Other - Middle Name:
Other - Last Name:BAKLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1502 HARWOOD RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-3084
Mailing Address - Country:US
Mailing Address - Phone:567-344-2188
Mailing Address - Fax:567-344-2188
Practice Address - Street 1:405 STATE HIGHWAY 121 BYP STE A250
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-4183
Practice Address - Country:US
Practice Address - Phone:214-813-6858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-08
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5779103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty