Individual
KATHERINE JANE MITCHEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA-D
Contact information
Practice address
827 FAIRMONT RD STE 207, MORGANTOWN, WV 26501-3857
(304) 241-5982
(304) 212-5462
Mailing address
27 IMPERIAL WOODS DR, MORGANTOWN, WV 26508-8128
(304) 276-2158
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-12-10165
WV
Other
Enumeration date
08/31/2017
Last updated
08/31/2017
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