Individual
KATELYNN NICOLE TAMMEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
971 E WICHITA AVE, RUSSELL, KS 67665-2444
(785) 324-2698
Mailing address
325 E 7TH ST, RUSSELL, KS 67665-3209
(785) 324-2698
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K03-86-6476
DRIVERS LICENSE
KS
Enumeration date
01/06/2023
Last updated
01/06/2023
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