Individual
KATELYN MARIE BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
727 BLACKBERRY RUN TRL, DALLAS, GA 30132-2129
(404) 290-3422
(678) 303-0347
Mailing address
727 BLACKBERRY RUN TRL, DALLAS, GA 30132-2129
(404) 290-3422
(678) 303-0347
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-27406
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003205692D
—
GA
Enumeration date
09/21/2017
Last updated
03/04/2020
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