Individual
KATIE REXROAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
12155 SW TOOZE RD, SHERWOOD, OR 97140-8441
(503) 570-0147
Mailing address
15982 SW ROTH DR, BEAVERTON, OR 97078-2101
(909) 997-6529
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-44236
OR
Other
Enumeration date
03/20/2017
Last updated
07/28/2021
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