Provider Demographics
NPI:1417763343
Name:CHAVIANO, KATHERINE ELISE (RBT)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ELISE
Last Name:CHAVIANO
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:KC
Other - Middle Name:
Other - Last Name:CHAVIANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10701 MELODY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80234-4133
Mailing Address - Country:US
Mailing Address - Phone:720-872-6472
Mailing Address - Fax:
Practice Address - Street 1:10701 MELODY DR STE 100
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80234-4133
Practice Address - Country:US
Practice Address - Phone:720-872-6472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician