Provider Demographics
NPI:1801437892
Name:LOVETT, KATHLEEN VICTORIA
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:VICTORIA
Last Name:LOVETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:962 CORONADO BLVD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSAL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78148-3228
Mailing Address - Country:US
Mailing Address - Phone:210-490-3900
Mailing Address - Fax:
Practice Address - Street 1:962 CORONADO BLVD
Practice Address - Street 2:
Practice Address - City:UNIVERSAL CITY
Practice Address - State:TX
Practice Address - Zip Code:78148-3228
Practice Address - Country:US
Practice Address - Phone:210-490-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-01
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8388106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst