Individual
KATHLEEN WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MT-BC, M.ED., BCBA
Contact information
Practice address
3341 E QUEEN CREEK RD STE 109, GILBERT, AZ 85297
(480) 621-8361
Mailing address
3450 E WILDHORSE DR, GILBERT, AZ 85297-7790
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BA-101
AZ
225A00000X
Music Therapist
05280
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05280
CERTIFICATION BOARD FOR MUSIC THERAPISTS
IL
01
—
1-12-10000
BEHAVIOR ANALYST CERTIFICATION BOARD
—
Enumeration date
01/22/2010
Last updated
12/16/2013
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