Provider Demographics
NPI:1750979696
Name:FOLEY, KATHLEEN (MA, BCBA)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:FOLEY
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 BABOOSIC LAKE RD
Mailing Address - Street 2:
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054-3657
Mailing Address - Country:US
Mailing Address - Phone:603-321-5320
Mailing Address - Fax:
Practice Address - Street 1:55 BABOOSIC LAKE RD
Practice Address - Street 2:
Practice Address - City:MERRIMACK
Practice Address - State:NH
Practice Address - Zip Code:03054-3657
Practice Address - Country:US
Practice Address - Phone:603-321-5320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH20-6621-257585103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst