Provider Demographics
NPI:1396464749
Name:FRAHM, KATELYN SAVANNAH (RBT)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:SAVANNAH
Last Name:FRAHM
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 W UNIVERSITY ST APT A307
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-7874
Mailing Address - Country:US
Mailing Address - Phone:417-824-3755
Mailing Address - Fax:
Practice Address - Street 1:1426 E BRADFORD PKWY STE J
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-6884
Practice Address - Country:US
Practice Address - Phone:314-275-0506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MORBT-22-217668103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst