Provider Demographics
NPI:1861857468
Name:DEUTCHER, KATRINA (RBT)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:DEUTCHER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3817 CONSTITUTION DR STE 100
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79922-1368
Mailing Address - Country:US
Mailing Address - Phone:915-226-0367
Mailing Address - Fax:915-232-9953
Practice Address - Street 1:3817 CONSTITUTION DR STE 100
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79922-1368
Practice Address - Country:US
Practice Address - Phone:915-226-0367
Practice Address - Fax:915-232-9953
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60597648225700000X
TXRBT-21-157071106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist