Provider Demographics
NPI:1962296707
Name:ADKINS, KATIE (RBT)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:ADKINS
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5248 PALM PINNACLE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-5682
Mailing Address - Country:US
Mailing Address - Phone:725-710-4529
Mailing Address - Fax:702-441-9140
Practice Address - Street 1:2450 CHANDLER AVE STE 4
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-4059
Practice Address - Country:US
Practice Address - Phone:725-710-4529
Practice Address - Fax:702-441-9140
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician