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General NPI Number Information
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NPI Number | 1003619628
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Entity Type | Individual
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Provider Name | KAITLIN MASTEN
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Gender | Female
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Dates
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Enumeration Date | 03/29/2025
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Last Update Date | 03/29/2025
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Provider Practice Location Address
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Address Line | 4103 E STAN SCHLUETER LOOP
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City | KILLEEN
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State | TX
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Zip | 76542-8551
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Country | US
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Telephone | 512-967-6955
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Fax |
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Provider Business Mailing Address
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Address Line | 706 MCLELLAN DR
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City | TEMPLE
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State | TX
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Zip | 76504-8729
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Country | US
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Telephone | 512-595-2177
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-25-423692
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License Number State | TX
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