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Individual

KATHIE HAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
700 UNIVERSITY DR E STE 106, COLLEGE STATION, TX 77840-1848
(210) 447-0039
Mailing address
1313 PARK ST, BRYAN, TX 77803-4973
(979) 255-4487

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-29898
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-18-29898
BACB CERTIFICATION
TX
Enumeration date
04/18/2018
Last updated
04/18/2018
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