Individual
MRS. KATELYN ROSE MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2904 FOLTZ DR, EDGEWOOD, KY 41017-2525
(859) 795-3000
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
245872
KY
103K00000X
Behavior Analyst
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-12-10191
BCBA CERTIFICATION
—
Enumeration date
03/07/2011
Last updated
03/20/2019
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