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General NPI Number Information
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NPI Number | 1366068819
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Entity Type | Individual
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Provider Name | KATHRYN DRYE MA, BCBA
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Gender | Female
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Dates
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Enumeration Date | 06/21/2020
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 900 TUTOR LN STE 107
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City | EVANSVILLE
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State | IN
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Zip | 47715-7295
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Country | US
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Telephone | 812-602-1038
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Fax | 812-602-1048
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Provider Business Mailing Address
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Address Line | 3130 GREEN RIVER DR APT 1231
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City | EVANSVILLE
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State | IN
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Zip | 47715-1492
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Country | US
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Telephone | 812-499-5923
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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 | 1-20-42052
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License Number State | IN
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