Individual
KATELYN DATSKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1630 PEACHTREE INDUSTRIAL BLVD APT 1109, SUWANEE, GA 30024-5576
(586) 871-7019
Mailing address
1630 PEACHTREE INDUSTRIAL BLVD APT 1109, SUWANEE, GA 30024-5576
(586) 871-7019
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-52663
GA
106S00000X
Behavior Technician
18-64273
MI
Other
Enumeration date
09/06/2018
Last updated
09/06/2021
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