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NPI Code Detail

MEDICARE: KATELYN VILLAR

MEDICARE: KATELYN VILLAR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1134640873
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATELYN VILLAR
Provider Business Mailing Address
First Line : 8413 COTTONWOOD DR
Second Line :
City : JENISON
State : MI
Zip : 49428-8327
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8413 COTTONWOOD DR
Second Line :
City : JENISON
State : MI
Zip : 49428-8327
Country : US
Telephone Number : 269-249-1489
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2017
Last Update Date : 05/27/2025

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Directions to “ KATELYN VILLAR ” Practice Location

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