Provider Demographics
NPI:1760723944
Name:SALARD, KATHRYN RENEE (MA, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:RENEE
Last Name:SALARD
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:RENEE
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:369 CYPRESS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:LA
Mailing Address - Zip Code:71463-6076
Mailing Address - Country:US
Mailing Address - Phone:318-794-2005
Mailing Address - Fax:
Practice Address - Street 1:369 CYPRESS CREEK RD
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:LA
Practice Address - Zip Code:71463-6076
Practice Address - Country:US
Practice Address - Phone:318-794-2005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-12
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst