Individual
KAITLIN LEE TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
125 REARDON BLVD, BARDSTOWN, KY 40004-2034
(877) 498-0319
Mailing address
102 FRONT NINE DR, ELIZABETHTOWN, KY 42701-9029
(270) 577-9635
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/26/2025
Last updated
03/26/2025
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