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General NPI Number Information
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NPI Number | 1407511397
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Entity Type | Individual
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Provider Name | MS. KATELYN A KATZ
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Gender | Female
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Dates
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Enumeration Date | 11/04/2021
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Last Update Date | 11/04/2021
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Provider Practice Location Address
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Address Line | 5000 GREENBAG RD STE A1
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City | MORGANTOWN
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State | WV
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Zip | 26501-7123
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Country | US
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Telephone | 304-241-8401
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Fax |
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Provider Business Mailing Address
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Address Line | 4032 PINEHURST DR
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City | MORGANTOWN
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State | WV
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Zip | 26505-8071
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Country | US
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Telephone | 304-241-8401
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-21-55063
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License Number State | WV
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