Basic Information
| Provider Information | |||||||||
| NPI: | 1396087706 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DENIGER | ||||||||
| FirstName: | KATHLEEN | ||||||||
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| Credential: | MPA BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 FEDERAL ST BLDG 101 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011051222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088080323 | ||||||||
| FaxNumber: | 4132242274 | ||||||||
| Practice Location | |||||||||
| Address1: | 34 RITTER ST | ||||||||
| Address2: | |||||||||
| City: | NASHUA | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030603736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088080323 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2013 | ||||||||
| LastUpdateDate: | 04/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 1-12-12627 | MA | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.