Provider Demographics
NPI:1619761954
Name:HOEFLICH, KATHLEEN R (BCBA)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:R
Last Name:HOEFLICH
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 MORNING MIST RD
Mailing Address - Street 2:
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-3522
Mailing Address - Country:US
Mailing Address - Phone:203-217-6162
Mailing Address - Fax:
Practice Address - Street 1:71 RAYMOND RD
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2211
Practice Address - Country:US
Practice Address - Phone:203-232-4398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst