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NPI Code Detail

MEDICARE: MRS. KATHLEEN KARIEL MT, BCBA, LBA

MEDICARE: MRS. KATHLEEN KARIEL MT, BCBA, LBA
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
1103K00000XBehavior Analyst0133000909VA

General Provider Information

NPI Number : 1962940122
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHLEEN KARIEL MT, BCBA, LBA
Provider Business Mailing Address
First Line : 943 GLENWOOD STATION LN
Second Line : SUITE 201
City : CHARLOTTESVILLE
State : VA
Zip : 22901-5714
Country : US
Telephone Number : 434-923-8252
Fax Number :
Provider Business Practice Location Address
First Line : 3500 REMSON CT
Second Line :
City : CHARLOTTESVILLE
State : VA
Zip : 22901-3508
Country : US
Telephone Number : 434-923-8252
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2017
Last Update Date : 10/15/2021

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