Katherine G Derozier
Individual provider Active NPI Behavior Analyst · Peru, IN
NPI 1043976822 · NPPES record last updated Nov 16, 2021
Key facts
- NPI
- 1043976822
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- Practice address
- 1039 N Harbour Pointe Dr
Peru, IN 46970-8695 - Phone
- (317) 690-3334
- NPI assigned
- Nov 16, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Yes |
Addresses
Primary practice location
1039 N Harbour Pointe Dr
Peru, IN 46970-8695
Mailing address
1039 N Harbour Pointe Dr
Peru, IN 46970-8695
Phone (317) 690-3334
Other providers in Peru, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.