Provider Demographics
NPI:1366068819
Name:DRYE, KATHRYN (MA, BCBA)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:DRYE
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 GREEN RIVER DR APT 1231
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-1492
Mailing Address - Country:US
Mailing Address - Phone:812-499-5923
Mailing Address - Fax:
Practice Address - Street 1:900 TUTOR LN STE 107
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-7295
Practice Address - Country:US
Practice Address - Phone:812-602-1038
Practice Address - Fax:812-602-1048
Is Sole Proprietor?:No
Enumeration Date:2020-06-21
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1-20-42052103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst