Basic Information
| Provider Information | |||||||||
| NPI: | 1922548858 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PAWLOWSKI | ||||||||
| FirstName: | KATELINN | ||||||||
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| Credential: | M.S., BCBA, LBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1500 S DOUGLAS RD STE 230 | ||||||||
| Address2: | |||||||||
| City: | CORAL GABLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331344108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8448541116 | ||||||||
| FaxNumber: | 3058469711 | ||||||||
| Practice Location | |||||||||
| Address1: | 42850 GARFIELD RD STE 101 | ||||||||
| Address2: | |||||||||
| City: | CLINTON TWP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480385026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5862618524 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/25/2017 | ||||||||
| LastUpdateDate: | 04/14/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 247200000X | N | Technologists, Technicians & Other Technical Service Providers | Technician, Other | 103K00000X | 7401001283 | MI | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.