Provider Demographics
NPI:1326798620
Name:SAHEBI, KATELYN ELIZABETH (NONE)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:ELIZABETH
Last Name:SAHEBI
Suffix:
Gender:F
Credentials:NONE
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:E
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NONE
Mailing Address - Street 1:227 NORTH LOOP 1604 EAST
Mailing Address - Street 2:#150
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232
Mailing Address - Country:US
Mailing Address - Phone:210-761-3504
Mailing Address - Fax:855-568-2494
Practice Address - Street 1:227 NORTH LOOP 1604 EAST
Practice Address - Street 2:#150
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232
Practice Address - Country:US
Practice Address - Phone:210-761-3504
Practice Address - Fax:855-568-2494
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNONE106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician