Provider Demographics
NPI:1538706023
Name:POOJAROEN, KATELYN EMILY (RBT)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:EMILY
Last Name:POOJAROEN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:1105 W RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-1322
Mailing Address - Country:US
Mailing Address - Phone:605-271-2690
Mailing Address - Fax:605-271-3956
Practice Address - Street 1:1410 14TH ST
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-6302
Practice Address - Country:US
Practice Address - Phone:605-271-2690
Practice Address - Fax:605-271-3956
Is Sole Proprietor?:No
Enumeration Date:2019-12-04
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXRBT-19-107092106S00000X
TX1-21-50317103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician