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General NPI Number Information
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NPI Number | 1891278008
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Entity Type | Individual
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Provider Name | KATHERINE TINEO
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Gender | Female
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Dates
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Enumeration Date | 09/13/2018
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Last Update Date | 07/23/2019
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Provider Practice Location Address
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Address Line | 2631 MERRICK RD STE 302
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City | BELLMORE
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State | NY
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Zip | 11710-5784
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Country | US
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Telephone | 516-590-7575
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Fax |
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Provider Business Mailing Address
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Address Line | 9436 45TH AVE
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City | ELMHURST
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State | NY
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Zip | 11373-2810
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Country | US
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Telephone | 646-764-0041
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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