Provider Demographics
NPI:1225627284
Name:WENRICH, KATIE (MS, BCBA, LBS)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:WENRICH
Suffix:
Gender:F
Credentials:MS, BCBA, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3755 TUNNEL HILL RD
Mailing Address - Street 2:
Mailing Address - City:SEVEN VALLEYS
Mailing Address - State:PA
Mailing Address - Zip Code:17360-8591
Mailing Address - Country:US
Mailing Address - Phone:717-460-2428
Mailing Address - Fax:888-411-1339
Practice Address - Street 1:3755 TUNNEL HILL RD
Practice Address - Street 2:
Practice Address - City:SEVEN VALLEYS
Practice Address - State:PA
Practice Address - Zip Code:17360-8591
Practice Address - Country:US
Practice Address - Phone:717-460-2428
Practice Address - Fax:888-411-1339
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1-20-45509103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst