Provider Demographics
NPI:1689313942
Name:CHAMPION, CATHERINE (RBT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:CHAMPION
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 VESTAVIA PKWY STE 2400
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35216-3797
Mailing Address - Country:US
Mailing Address - Phone:205-490-3931
Mailing Address - Fax:
Practice Address - Street 1:200 VESTAVIA PKWY
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35216-7715
Practice Address - Country:US
Practice Address - Phone:205-490-3931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-03
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
ALRBT-22-216807106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst