Provider Demographics
NPI:1649768482
Name:TUCKER, CATHERINE SCOTT (BCBA, MED)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:SCOTT
Last Name:TUCKER
Suffix:
Gender:F
Credentials:BCBA, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2233 CAHABA VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2602
Mailing Address - Country:US
Mailing Address - Phone:205-994-4474
Mailing Address - Fax:
Practice Address - Street 1:2233 CAHABA VALLEY DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-2602
Practice Address - Country:US
Practice Address - Phone:205-994-4474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-26
Last Update Date:2023-06-27
Deactivation Date:2019-12-26
Deactivation Code:
Reactivation Date:2023-06-27
Provider Licenses
StateLicense IDTaxonomies
AL2023-060103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst