MEDICARE: CATHERINE GLENDA AALIYAH MCKOY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1164194361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE GLENDA AALIYAH MCKOY

Provider Business Mailing Address
First Line	:	211 GRAND AVE APT 3307
Second Line	:
City	:	CIBOLO
State	:	TX
Zip	:	78108-0484
Country	:	US
Telephone Number	:	907-317-1533
Fax Number	:

Provider Business Practice Location Address
First Line	:	7110 FM 78 STE 102
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78244-1765
Country	:	US
Telephone Number	:	855-782-7822
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2021
Last Update Date	:	05/30/2025

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Directions to “ CATHERINE GLENDA AALIYAH MCKOY ” Practice Location

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