Provider Demographics
NPI:1366957409
Name:LINKENHOKER, KATHERINE MAE (QBA, LBA)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MAE
Last Name:LINKENHOKER
Suffix:
Gender:F
Credentials:QBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 E 43RD AVE SIDE B
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5424
Mailing Address - Country:US
Mailing Address - Phone:907-903-4903
Mailing Address - Fax:
Practice Address - Street 1:2330 E 42ND AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5204
Practice Address - Country:US
Practice Address - Phone:907-313-6345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
AK229200103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKRBT-17-34667OtherTRI-CARE