Provider Demographics
NPI:1770956724
Name:GOWER, KATELYN (BCBA)
Entity type:Individual
Prefix:MRS
First Name:KATELYN
Middle Name:
Last Name:GOWER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6510 HEDGE LANE TER APT 101
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66226-4854
Mailing Address - Country:US
Mailing Address - Phone:913-221-3574
Mailing Address - Fax:
Practice Address - Street 1:620 S ROGERS RD
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1704
Practice Address - Country:US
Practice Address - Phone:913-764-2887
Practice Address - Fax:913-780-3387
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-12
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS113103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst