Provider Demographics
NPI:1285395384
Name:IRVING, KATHRYN ADELE (BCBA)
Entity type:Individual
Prefix:MISS
First Name:KATHRYN
Middle Name:ADELE
Last Name:IRVING
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 BEEBETOWN RD
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-2339
Mailing Address - Country:US
Mailing Address - Phone:856-524-2066
Mailing Address - Fax:
Practice Address - Street 1:420 SECOND AVE
Practice Address - Street 2:
Practice Address - City:WEST CAPE MAY
Practice Address - State:NJ
Practice Address - Zip Code:08204-1045
Practice Address - Country:US
Practice Address - Phone:201-675-0316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-02
Last Update Date:2022-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst