MEDICARE: KATHERINE PALLADINO BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	BACB229398

General Provider Information

NPI Number	:	1164858247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE PALLADINO BCBA

Provider Business Mailing Address
First Line	:	11 DEE DEE DR
Second Line	:
City	:	SANDOWN
State	:	NH
Zip	:	03873-2030
Country	:	US
Telephone Number	:	978-729-5649
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 DEE DEE DR
Second Line	:
City	:	SANDOWN
State	:	NH
Zip	:	03873-2030
Country	:	US
Telephone Number	:	978-729-5649
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2013
Last Update Date	:	08/28/2023

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