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General NPI Number Information
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NPI Number | 1255835773
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Entity Type | Individual
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Provider Name | KATHERINE GAGNE BCBA, LBA
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Gender | Female
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Dates
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Enumeration Date | 03/20/2018
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 12430 TESSON FERRY RD #102
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City | SAINT LOUIS
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State | MO
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Zip | 63128-2702
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Country | US
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Telephone | 855-832-6727
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Fax | 772-675-9100
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Provider Business Mailing Address
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Address Line | 12430 TESSON FERRY RD #102
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City | SAINT LOUIS
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State | MO
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Zip | 63128-2702
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Country | US
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Telephone | 703-679-8418
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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 | 0133002995
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License Number State | VA
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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 | 2025042811
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License Number State | MO
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Taxonomy #3
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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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