MEDICARE: KATHLEEN VICTORIA LOVETT

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	106E00000X	Assistant Behavior Analyst	8388	TX

General Provider Information

NPI Number	:	1801437892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN VICTORIA LOVETT

Provider Business Mailing Address
First Line	:	962 CORONADO BLVD
Second Line	:
City	:	UNIVERSAL CITY
State	:	TX
Zip	:	78148-3228
Country	:	US
Telephone Number	:	210-490-3900
Fax Number	:

Provider Business Practice Location Address
First Line	:	962 CORONADO BLVD
Second Line	:
City	:	UNIVERSAL CITY
State	:	TX
Zip	:	78148-3228
Country	:	US
Telephone Number	:	210-490-3900
Fax Number	:

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

Provider Enumeration Date	:	10/01/2019
Last Update Date	:	07/23/2025

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