Provider Demographics
NPI:1235962622
Name:KATY AULL THERAPY LLC
Entity type:Organization
Organization Name:KATY AULL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:KATY
Authorized Official - Last Name:AULL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:573-446-6290
Mailing Address - Street 1:2804 FORUM BLVD STE 3A
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-6661
Mailing Address - Country:US
Mailing Address - Phone:573-446-6290
Mailing Address - Fax:
Practice Address - Street 1:2804 FORUM BLVD STE 3A
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-6661
Practice Address - Country:US
Practice Address - Phone:573-446-6290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty