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NPI Code Detail

MEDICARE: MRS. CATHERINE GRAHAM EASON BCBA, LPA

MEDICARE:  MRS. CATHERINE GRAHAM EASON  BCBA, LPA
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
1103K00000XBehavior Analyst1-16-21741CO
2103T00000XPsychologist6145NC
3222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1861867574
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CATHERINE GRAHAM EASON BCBA, LPA
Provider Business Mailing Address
First Line : 500 FAIRWAY DR STE 102
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33441-1817
Country : US
Telephone Number : 888-880-9270
Fax Number :
Provider Business Practice Location Address
First Line : 3317 MASONBORO LOOP RD UNIT 150
Second Line :
City : WILMINGTON
State : NC
Zip : 28409-2970
Country : US
Telephone Number : 910-599-5307
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2015
Last Update Date : 09/23/2022

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