Healthcare Provider Details

I. General information

NPI: 1851932859
Provider Name (Legal Business Name): KATHERINE HANLEY M.ED. BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2019
Last Update Date: 10/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8408 STACY RD STE 300
MCKINNEY TX
75070-2422
US

IV. Provider business mailing address

5521 CRESTWOOD DR
PROSPER TX
75078-5621
US

V. Phone/Fax

Practice location:
  • Phone: 469-625-2193
  • Fax:
Mailing address:
  • Phone: 469-955-4622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-19-37936
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: