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NPI Code Detail

MEDICARE: KATHERINE CONNOR

MEDICARE:   KATHERINE  CONNOR
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 TechnicianRBT-23-281895SC

General Provider Information

NPI Number : 1235914201
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE CONNOR
Provider Business Mailing Address
First Line : PO BOX 931142
Second Line :
City : ATLANTA
State : GA
Zip : 31193-1142
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2460 INDIA HOOK RD STE 105
Second Line :
City : ROCK HILL
State : SC
Zip : 29732-3531
Country : US
Telephone Number : 803-366-6250
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2023
Last Update Date : 08/29/2023

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Directions to “ KATHERINE CONNOR ” Practice Location

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