Provider Demographics
NPI:1679360747
Name:TOWNSEND, KATLYN
Entity type:Individual
Prefix:MRS
First Name:KATLYN
Middle Name:
Last Name:TOWNSEND
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 1:433 N 45TH ST
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-3824
Mailing Address - Country:US
Mailing Address - Phone:903-519-8577
Mailing Address - Fax:
Practice Address - Street 1:914 S MEADOWS DR
Practice Address - Street 2:
Practice Address - City:DIBOLL
Practice Address - State:TX
Practice Address - Zip Code:75941-2805
Practice Address - Country:US
Practice Address - Phone:724-246-4237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-23-285853106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician