Katherine Angel

Individual provider Active NPI Behavior Technician · Russellville, AR

NPI 1932809167 · NPPES record last updated Mar 7, 2023

Key facts

NPI
1932809167
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
301 N Sidney Ave
Russellville, AR 72801-4383
Phone
(479) 890-5494
NPI assigned
Mar 7, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Kid Success, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X AR Yes

Addresses

Primary practice location

301 N Sidney Ave
Russellville, AR 72801-4383

Mailing address

301 N Sidney Ave
Russellville, AR 72801-4383
Phone (479) 890-5494

Other providers in Russellville, AR

All providers in Russellville, AR · Behavior Technician in Arkansas

Sources for this page

Verify at the official NPI Registry.