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NPI Code Detail

MEDICARE: KATIE CHAMBERLAIN BCBA

MEDICARE: KATIE CHAMBERLAIN BCBA
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
1103K00000XBehavior Analyst11623318TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111623318OTHERTXBCBA

General Provider Information

NPI Number : 1174063143
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE CHAMBERLAIN BCBA
Provider Business Mailing Address
First Line : 10503 METRIC DR
Second Line :
City : DALLAS
State : TX
Zip : 75243-5514
Country : US
Telephone Number : 214-221-4405
Fax Number : 214-221-0069
Provider Business Practice Location Address
First Line : 10503 METRIC DR
Second Line :
City : DALLAS
State : TX
Zip : 75243-5514
Country : US
Telephone Number : 214-221-4405
Fax Number : 214-221-0069
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2017
Last Update Date : 02/24/2017

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Directions to “ KATIE CHAMBERLAIN BCBA” Practice Location

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