Provider Demographics
NPI:1699072447
Name:LYNCH, KATHERINE (MED, BCBA, LBA)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MED, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10200 NI RIVER DR
Mailing Address - Street 2:
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22553-3741
Mailing Address - Country:US
Mailing Address - Phone:540-693-0830
Mailing Address - Fax:540-301-2131
Practice Address - Street 1:10200 NI RIVER DR
Practice Address - Street 2:
Practice Address - City:SPOTSYLVANIA
Practice Address - State:VA
Practice Address - Zip Code:22553-3741
Practice Address - Country:US
Practice Address - Phone:540-693-0830
Practice Address - Fax:540-301-2131
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-14
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-10-7430103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst