Provider Demographics
NPI:1164094363
Name:WILKEY, KATLYNNE MICHELLE
Entity Type:Individual
Prefix:
First Name:KATLYNNE
Middle Name:MICHELLE
Last Name:WILKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16341 MUESCHKE RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433
Mailing Address - Country:US
Mailing Address - Phone:832-334-5194
Mailing Address - Fax:
Practice Address - Street 1:16341 MUESCHKE RD
Practice Address - Street 2:SUITE 150
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-7743
Practice Address - Country:US
Practice Address - Phone:832-334-5194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-20-134153106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician