Provider Demographics
NPI:1326579145
Name:NIELSEN, KATELYNN CHRISTINE
Entity Type:Individual
Prefix:MISS
First Name:KATELYNN
Middle Name:CHRISTINE
Last Name:NIELSEN
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 1:6088 COORS COURT
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-6154
Mailing Address - Country:US
Mailing Address - Phone:720-403-0530
Mailing Address - Fax:
Practice Address - Street 1:304 INVERNESS WAY S
Practice Address - Street 2:#125
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-5828
Practice Address - Country:US
Practice Address - Phone:303-759-1342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician