Provider Demographics
NPI:1265039598
Name:WATKINS, KAYCIE
Entity type:Individual
Prefix:
First Name:KAYCIE
Middle Name:
Last Name:WATKINS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 BROOKSIDE PL
Mailing Address - Street 2:
Mailing Address - City:COLWICH
Mailing Address - State:KS
Mailing Address - Zip Code:67030-9683
Mailing Address - Country:US
Mailing Address - Phone:316-364-8765
Mailing Address - Fax:
Practice Address - Street 1:1319 W MAY ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67213-3505
Practice Address - Country:US
Practice Address - Phone:316-364-8765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-09
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician