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NPI Code Detail

MEDICARE: KATELYN CHEESEMAN

MEDICARE:   KATELYN  CHEESEMAN
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
1222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1427421379
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATELYN CHEESEMAN
Provider Business Mailing Address
First Line : 500 FAIRWAY DR STE 102
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33441-1817
Country : US
Telephone Number : 888-880-9270
Fax Number :
Provider Business Practice Location Address
First Line : 560 HAIGHT ST
Second Line : #104
City : SAN FRANCISCO
State : CA
Zip : 94117-3431
Country : US
Telephone Number : 888-880-9270
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2015
Last Update Date : 11/01/2015

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Directions to “ KATELYN CHEESEMAN ” Practice Location

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