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General NPI Number Information
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NPI Number | 1801181417
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Entity Type | Individual
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Provider Name | CATHERINE DIANE IRWIN BCBA
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Gender | Female
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Dates
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Enumeration Date | 06/10/2011
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Last Update Date | 06/10/2011
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Provider Practice Location Address
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Address Line | 2735 SUNRUNNER LN
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City | GULF BREEZE
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State | FL
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Zip | 32563-5510
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Country | US
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Telephone | 850-934-5857
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Fax | 859-916-6590
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Provider Business Mailing Address
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Address Line | 2735 SUNRUNNER LN
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City | GULF BREEZE
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State | FL
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Zip | 32563-5510
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Country | US
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Telephone | 850-934-5857
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Fax | 859-916-6590
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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 | 1-03-1049
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License Number State | FL
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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 | 1031049
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License Number State | FL
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