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General NPI Number Information
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NPI Number | 1124454202
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Entity Type | Individual
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Provider Name | CATHERINE ANNE LE MOINE MA, BCBA
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Gender | Female
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Dates
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Enumeration Date | 09/19/2013
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Last Update Date | 07/11/2014
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Provider Practice Location Address
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Address Line | 8200 WOODGLEN LN APT 201
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City | DOWNERS GROVE
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State | IL
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Zip | 60516-4525
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Country | US
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Telephone | 603-709-5910
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Fax |
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Provider Business Mailing Address
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Address Line | 3065 S 54TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53219-3355
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Country | US
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Telephone | 414-659-0482
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-14-16735
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License Number State | WI
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