Provider Demographics
NPI:1972930162
Name:THOMAS, KATHERINE A (BCBA)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:A
Last Name:THOMAS
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 1:4243 CHERRYHURST CT
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-6887
Mailing Address - Country:US
Mailing Address - Phone:908-313-3548
Mailing Address - Fax:
Practice Address - Street 1:2091 KERR GULCH RD
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-6398
Practice Address - Country:US
Practice Address - Phone:720-339-1309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-13-13190103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst