Healthcare Provider Details
I. General information
NPI: 1174270870
Provider Name (Legal Business Name): KATHRYN DUARTE BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/03/2022
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date: 12/08/2025
Reactivation Date: 12/16/2025
III. Provider practice location address
433 HEISLEY PARK LN
PAINESVILLE OH
44077-6119
US
IV. Provider business mailing address
433 HEISLEY PARK LN
PAINESVILLE OH
44077-6119
US
V. Phone/Fax
- Phone: 404-339-0874
- Fax:
- Phone: 404-339-0874
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 1-25-81782 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | RBT-21-185661 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: