Healthcare Provider Details

I. General information

NPI: 1265955769
Provider Name (Legal Business Name): KATE PATTERSON BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2017
Last Update Date: 12/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 E MARKET ST STE C
CHARLOTTESVILLE VA
22902-5374
US

IV. Provider business mailing address

1006 E MARKET ST STE C
CHARLOTTESVILLE VA
22902-5374
US

V. Phone/Fax

Practice location:
  • Phone: 434-220-0089
  • Fax: 434-220-0103
Mailing address:
  • Phone: 434-220-0089
  • Fax: 434-220-0103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0133000944
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: