Healthcare Provider Details

I. General information

NPI: 1144886094
Provider Name (Legal Business Name): KATELYN MARIE KAMINSKY BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2019
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 S QUEBEC ST STE 100C
GREENWOOD VILLAGE CO
80111-2210
US

IV. Provider business mailing address

2215 E 126TH WAY
THORNTON CO
80241-2637
US

V. Phone/Fax

Practice location:
  • Phone: 720-706-3396
  • Fax:
Mailing address:
  • Phone: 386-848-9449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: