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NPI Code Detail

MEDICARE: KATIE CULLUM

MEDICARE: KATIE CULLUM
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 Technician

General Provider Information

NPI Number : 1730010281
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE CULLUM
Provider Business Mailing Address
First Line : 351 BALLENGER CENTER DR STE 102
Second Line :
City : FREDERICK
State : MD
Zip : 21703-7384
Country : US
Telephone Number : 240-342-2666
Fax Number :
Provider Business Practice Location Address
First Line : 351 BALLENGER CENTER DR STE 102
Second Line :
City : FREDERICK
State : MD
Zip : 21703-7384
Country : US
Telephone Number : 240-342-2666
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2026
Last Update Date : 05/26/2026

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Directions to “ KATIE CULLUM ” Practice Location

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