Provider Demographics
NPI:1588043525
Name:ROCKWELL, KATERINA ELIZABETH (MA, BCBA)
Entity Type:Individual
Prefix:MS
First Name:KATERINA
Middle Name:ELIZABETH
Last Name:ROCKWELL
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:MS
Other - First Name:KATERINA
Other - Middle Name:ELIZABETH
Other - Last Name:NORWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:N27W23953 PAUL RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:PEWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53072-6242
Mailing Address - Country:US
Mailing Address - Phone:815-262-6372
Mailing Address - Fax:
Practice Address - Street 1:N27W23953 PAUL RD STE 206
Practice Address - Street 2:
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53072-6244
Practice Address - Country:US
Practice Address - Phone:262-347-0701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-22
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI114-140103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst