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General NPI Number Information
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NPI Number | 1215575659
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Entity Type | Individual
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Provider Name | KATHRYN ANN HENDERSON BCBA, LBA
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Gender | Female
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Dates
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Enumeration Date | 12/17/2019
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Last Update Date | 09/17/2023
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Provider Practice Location Address
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Address Line | 4906 CUTSHAW AVE STE 200
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City | RICHMOND
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State | VA
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Zip | 23230-3630
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Country | US
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Telephone | 129-652-9973
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Fax | 312-929-0324
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Provider Business Mailing Address
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Address Line | 640 GRASSMERE PARK STE 116
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City | NASHVILLE
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State | TN
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Zip | 37211-3678
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Country | US
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Telephone | 844-854-1116
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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