MEDICARE: KATRINA ALLEN

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
1	101YM0800X	Mental Health Counselor		NV
2	103K00000X	Behavior Analyst	RBT-19-99366	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568851798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATRINA ALLEN

Provider Business Mailing Address
First Line	:	6133 KINDERHOOK CT
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-6400
Country	:	US
Telephone Number	:	702-969-5153
Fax Number	:

Provider Business Practice Location Address
First Line	:	6133 KINDERHOOK CT
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-6400
Country	:	US
Telephone Number	:	702-969-5153
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2015
Last Update Date	:	05/01/2024

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Directions to “ KATRINA ALLEN ” Practice Location

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