Provider Demographics
NPI:1205590783
Name:SHOWALTER, ESTELA CAROLINA (RBT)
Entity type:Individual
Prefix:MS
First Name:ESTELA
Middle Name:CAROLINA
Last Name:SHOWALTER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:ESTELITA
Other - Middle Name:CAROLINA
Other - Last Name:SHOWALTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RBT
Mailing Address - Street 1:208 EDGEFORD DR
Mailing Address - Street 2:
Mailing Address - City:PRATT
Mailing Address - State:KS
Mailing Address - Zip Code:67124-1924
Mailing Address - Country:US
Mailing Address - Phone:620-352-1144
Mailing Address - Fax:
Practice Address - Street 1:208 EDGEFORD DR
Practice Address - Street 2:
Practice Address - City:PRATT
Practice Address - State:KS
Practice Address - Zip Code:67124-1924
Practice Address - Country:US
Practice Address - Phone:620-352-1144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-29
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS106E00000X
106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst