Provider Demographics
NPI:1487495867
Name:ENGE, KATHARINA DANIELA (RBT)
Entity type:Individual
Prefix:
First Name:KATHARINA
Middle Name:DANIELA
Last Name:ENGE
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 1:52604 SENECA CT UNIT 1
Mailing Address - Street 2:
Mailing Address - City:FORT CAVAZOS
Mailing Address - State:TX
Mailing Address - Zip Code:76544-1025
Mailing Address - Country:US
Mailing Address - Phone:210-557-9700
Mailing Address - Fax:
Practice Address - Street 1:4520 E CENTRAL TEXAS EXPY STE 111
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76543-5276
Practice Address - Country:US
Practice Address - Phone:254-213-1311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-01
Last Update Date:2024-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-24-351121106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician