Provider Demographics
NPI:1639594179
Name:TRIPLETT, KATHERINE LAURA (BCABA)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LAURA
Last Name:TRIPLETT
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 NW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-4020
Mailing Address - Country:US
Mailing Address - Phone:352-373-4411
Mailing Address - Fax:321-765-6434
Practice Address - Street 1:1408 NW 6TH ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-4020
Practice Address - Country:US
Practice Address - Phone:352-373-4411
Practice Address - Fax:321-765-6434
Is Sole Proprietor?:No
Enumeration Date:2014-02-20
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1732337106S00000X
106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1732337OtherRBT