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General NPI Number Information
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NPI Number | 1710339171
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Entity Type | Individual
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Provider Name | KATLYN BUSHEY
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Gender | Female
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Dates
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Enumeration Date | 07/11/2016
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 4727 W IRLO BRONSON MEMORIAL HWY
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City | KISSIMMEE
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State | FL
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Zip | 34746-5326
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Country | US
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Telephone | 407-978-6085
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Fax | 321-445-9760
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Provider Business Mailing Address
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Address Line | 505 CYPRESS AVE
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City | SANFORD
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State | FL
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Zip | 32771-1956
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Country | US
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Telephone |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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