Provider Demographics
NPI:1265297550
Name:JONES MCQUILLAN, KATHRYN (BCBA)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:JONES MCQUILLAN
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 1:20 LILY POND RD APT 3A
Mailing Address - Street 2:
Mailing Address - City:WHITE RIVER JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05001-6208
Mailing Address - Country:US
Mailing Address - Phone:603-443-0879
Mailing Address - Fax:
Practice Address - Street 1:92 FARMVU DR
Practice Address - Street 2:
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05001-6001
Practice Address - Country:US
Practice Address - Phone:802-698-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-16
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT147.0123018106E00000X
VT146.0134416103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst