Individual
KATHLEEN MOONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
109 OAK ST, NEWTON, MA 02464-1492
(617) 658-5611
Mailing address
523 E 78TH ST APT 3F, NEW YORK, NY 10075-1164
(203) 598-2890
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-54050
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U4385410904
CIGNA
CT
Enumeration date
08/07/2017
Last updated
05/19/2022
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