MEDICARE: KATERINA FUENTES

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1598693202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATERINA FUENTES

Provider Business Mailing Address
First Line	:	8115 MAPLE LAWN BLVD STE 350
Second Line	:
City	:	FULTON
State	:	MD
Zip	:	20759-2683
Country	:	US
Telephone Number	:	229-416-2750
Fax Number	:

Provider Business Practice Location Address
First Line	:	2515 CENTRAL AVE APT 6
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-3618
Country	:	US
Telephone Number	:	229-416-2750
Fax Number	:

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

Provider Enumeration Date	:	05/12/2026
Last Update Date	:	05/12/2026

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Directions to “ KATERINA FUENTES ” Practice Location

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