Provider Demographics
NPI:1285306514
Name:MEDUNA, KATHERINE TAYLOR (MA BCBA)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:TAYLOR
Last Name:MEDUNA
Suffix:
Gender:F
Credentials:MA BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 STOLE ACRES
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:TX
Mailing Address - Zip Code:78124
Mailing Address - Country:US
Mailing Address - Phone:903-244-7798
Mailing Address - Fax:
Practice Address - Street 1:790 GENERATIONS DR
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-0086
Practice Address - Country:US
Practice Address - Phone:830-256-9730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-21-53794103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst