Kelley L Kautzman
Individual provider Active NPI Behavior Technician · Cosmopolis, WA
NPI 1285072157 · NPPES record last updated Dec 1, 2020
Key facts
- NPI
- 1285072157
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 106 F Street
Cosmopolis, WA 98537 - Phone
- (360) 915-6868
- NPI assigned
- Jun 12, 2013
- Sex
- Female
- Sole proprietor
- No
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 | |||
| Speech-Language Assistant | 2355S0801X | |||
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
106 F Street
Cosmopolis, WA 98537
Mailing address
PO Box 136
Westport, WA 98595-0136
Phone (360) 589-0675
Other practice location 1
2580 S Montesano St
Westport, WA 98595-9746
Phone (360) 268-9125 ext. 108
Other providers in Cosmopolis, WA
- Amanda N Anderson
- Tanya Natalia Bechold
- Lacie Irene Jenkins
- Shirley Mariah Luark
- Coral Peters
- Veronica G Schmidt
- Paige Snodgrass
- Melissa Nicole Sturgill
All providers in Cosmopolis, WA · Behavior Technician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2020. 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.