Provider Demographics
NPI:1306082987
Name:MUELLER, KATHY J (BCBA)
Entity type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:J
Last Name:MUELLER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4891 GLOVER LN
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-4556
Mailing Address - Country:US
Mailing Address - Phone:850-554-1077
Mailing Address - Fax:850-983-6132
Practice Address - Street 1:4891 GLOVER LN
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-4556
Practice Address - Country:US
Practice Address - Phone:850-554-1077
Practice Address - Fax:850-983-6132
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-01
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-08-4800103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst