Provider Demographics
NPI:1063137537
Name:BOZARTH, KATHERINE (MA, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:BOZARTH
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1729 ABERDEEN CT
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-1623
Mailing Address - Country:US
Mailing Address - Phone:443-366-2234
Mailing Address - Fax:
Practice Address - Street 1:1729 ABERDEEN CT
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-1623
Practice Address - Country:US
Practice Address - Phone:443-366-2234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-07
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1394103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst