Provider Information for 1407272545
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Ms. KATIE ELIZABETH LANDRUM BCBA
Sex: Female
NPI: 1407272545
Last Updated: 2023-05-05
Certification Date: 2023-05-05
Certification Date: 2023-05-05
Details
| Name | Value | ||||||||||||||||
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| NPI | 1407272545 | ||||||||||||||||
| Enumeration Date | 2014-03-13 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 1028 SPRING LANDING DR WINTER GARDEN, FL 34787-2126 United States Phone: 407-928-4062 | Fax: | ||||||||||||||||
| Primary Practice Address | 907 OUTER RD STE B ORLANDO, FL 32814-6601 United States Phone: 407-928-4062 | Fax: | ||||||||||||||||
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