MEDICARE: MS. KATHERINE ROSE DONAHOE M.S., 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	1-15-19896	VA

General Provider Information

NPI Number	:	1740736131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHERINE ROSE DONAHOE M.S., BCBA

Provider Business Mailing Address
First Line	:	1792 S 8TH ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80905-1959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1230 TENDERFOOT HILL RD
Second Line	:	SUITE 305
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-7346
Country	:	US
Telephone Number	:	719-266-1000
Fax Number	:

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

Provider Enumeration Date	:	08/26/2016
Last Update Date	:	08/26/2016

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