MEDICARE: KATIE ANN MCCONNON

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		OH

General Provider Information

NPI Number	:	1982573481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE ANN MCCONNON

Provider Business Mailing Address
First Line	:	6058 EMERALD ST
Second Line	:
City	:	NORTH RIDGEVILLE
State	:	OH
Zip	:	44039-2046
Country	:	US
Telephone Number	:	440-596-7351
Fax Number	:

Provider Business Practice Location Address
First Line	:	6058 EMERALD ST
Second Line	:
City	:	NORTH RIDGEVILLE
State	:	OH
Zip	:	44039-2046
Country	:	US
Telephone Number	:	440-596-7351
Fax Number	:

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

Provider Enumeration Date	:	11/03/2025
Last Update Date	:	11/03/2025

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Directions to “ KATIE ANN MCCONNON ” Practice Location

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