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NPI Code Detail

MEDICARE: MS. KATHERINE GRACE VAN TIMMEREN MSW

MEDICARE: MS. KATHERINE GRACE VAN TIMMEREN MSW
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 TechnicianGA
2103K00000XBehavior AnalystL-1091LA

General Provider Information

NPI Number : 1457960221
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHERINE GRACE VAN TIMMEREN MSW
Provider Business Mailing Address
First Line : 5349 FLANDERS DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70808-4349
Country : US
Telephone Number : 225-256-1723
Fax Number :
Provider Business Practice Location Address
First Line : 5349 FLANDERS DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70808-4349
Country : US
Telephone Number : 225-485-0248
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2020
Last Update Date : 02/13/2026

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