Provider Demographics
NPI:1962868224
Name:HERMAN, KATHRYN ANN (BCBA)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANN
Last Name:HERMAN
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 1:6343 E GIRARD PL
Mailing Address - Street 2:UNIT 372
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-7408
Mailing Address - Country:US
Mailing Address - Phone:847-346-7306
Mailing Address - Fax:
Practice Address - Street 1:400 S COLORADO BLVD
Practice Address - Street 2:STE 400
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1253
Practice Address - Country:US
Practice Address - Phone:303-322-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-01
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-15-21160103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst