Healthcare Provider Details

I. General information

NPI: 1265297550
Provider Name (Legal Business Name): KATHRYN JONES MCQUILLAN BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2024
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 E LEWIS ST
LIVINGSTON MT
59047-3115
US

IV. Provider business mailing address

2285 TSCHACHE LN APT 106
BOZEMAN MT
59718-2226
US

V. Phone/Fax

Practice location:
  • Phone: 406-823-0342
  • Fax:
Mailing address:
  • Phone: 603-443-0879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number146.0134416
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberPSY-BA-LIC-6192
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number147.0123018
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: