Provider Demographics
NPI:1720437718
Name:FIELD LEWIS, KATHARINE JANELLE (BCBA)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:JANELLE
Last Name:FIELD LEWIS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:KATHARINE
Other - Middle Name:JANELLE
Other - Last Name:FIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3182 BROCKENHURST DR
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-7627
Mailing Address - Country:US
Mailing Address - Phone:470-266-0594
Mailing Address - Fax:
Practice Address - Street 1:3182 BROCKENHURST DR
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-7627
Practice Address - Country:US
Practice Address - Phone:470-266-0594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst