Individual
KATIE BRADFORD HEITMULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
279 TOWN PL STE 279, FAIRVIEW, TX 75069-1823
(248) 299-0030
Mailing address
279 TOWN PL STE 279, FAIRVIEW, TX 75069-1823
(248) 299-0030
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
5397
TX
106S00000X
Behavior Technician
RBT-18-73020
LA
106S00000X
Behavior Technician
RBT-18-73020
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-18-73020
BACB
LA
Enumeration date
04/25/2019
Last updated
04/04/2023
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