Provider Demographics
NPI:1629692199
Name:OCONNOR, KATHLEEN STARR (M ED, BCBA, LABA)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:STARR
Last Name:OCONNOR
Suffix:
Gender:F
Credentials:M ED, BCBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:871 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02127-5670
Mailing Address - Country:US
Mailing Address - Phone:203-640-7412
Mailing Address - Fax:
Practice Address - Street 1:555 VIRGINIA RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2770
Practice Address - Country:US
Practice Address - Phone:781-674-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-01
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3038103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst