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NPI Code Detail

MEDICARE: KATHERINE MERRICK BCBA

MEDICARE: KATHERINE MERRICK BCBA
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 Analyst11314041IN

General Provider Information

NPI Number : 1467884247
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE MERRICK BCBA
Provider Business Mailing Address
First Line : 1353 E MAIN ST
Second Line :
City : BROWNSBURG
State : IN
Zip : 46112-1433
Country : US
Telephone Number : 317-520-4748
Fax Number :
Provider Business Practice Location Address
First Line : 1353 E MAIN ST
Second Line :
City : BROWNSBURG
State : IN
Zip : 46112-1433
Country : US
Telephone Number : 317-520-4748
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2013
Last Update Date : 05/18/2023

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