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NPI Code Detail

MEDICARE: KATELYN EVANS

MEDICARE:   KATELYN  EVANS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1023682408
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATELYN EVANS
Provider Business Mailing Address
First Line : 85 HAWTHORNE ST
Second Line :
City : BELMONT
State : MA
Zip : 02478-1919
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 85 HAWTHORNE ST
Second Line :
City : BELMONT
State : MA
Zip : 02478-1919
Country : US
Telephone Number : 617-866-7523
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2021
Last Update Date : 05/19/2021

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Directions to “ KATELYN EVANS ” Practice Location

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