Provider Demographics
NPI:1427624006
Name:CHENOWETH, KAITLYN EMERY
Entity type:Individual
Prefix:MRS
First Name:KAITLYN
Middle Name:EMERY
Last Name:CHENOWETH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S TWIN CREEK DR APT 13E
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76543-4732
Mailing Address - Country:US
Mailing Address - Phone:737-210-0807
Mailing Address - Fax:
Practice Address - Street 1:2904 E STAN SCHLUETER LOOP
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-4813
Practice Address - Country:US
Practice Address - Phone:254-294-4488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician