Provider Demographics
NPI:1689159675
Name:MCLAUGHLIN, KATHRYN MARY (BCBA)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MARY
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6730 CLYDE ST APT 7T
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4063
Mailing Address - Country:US
Mailing Address - Phone:314-630-9667
Mailing Address - Fax:
Practice Address - Street 1:6730 CLYDE ST APT 7T
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4063
Practice Address - Country:US
Practice Address - Phone:314-630-9667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-17-27624103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst