Provider Demographics
NPI:1124839899
Name:TELLEZ, KATHLEEN (FDNP)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:TELLEZ
Suffix:
Gender:F
Credentials:FDNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 COLTHORPE LN
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-2248
Mailing Address - Country:US
Mailing Address - Phone:512-777-8392
Mailing Address - Fax:
Practice Address - Street 1:520 COLTHORPE LN
Practice Address - Street 2:
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634-2248
Practice Address - Country:US
Practice Address - Phone:512-777-8392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach