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NPI Code Detail

MEDICARE: CAITLYN EMILIE PASSINO

MEDICARE: CAITLYN EMILIE PASSINO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1417562661
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAITLYN EMILIE PASSINO
Provider Business Mailing Address
First Line : 29566 NORTHWESTERN HWY STE 100
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48034-1036
Country : US
Telephone Number : 833-328-8476
Fax Number :
Provider Business Practice Location Address
First Line : 29566 NORTHWESTERN HWY STE 100
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48034-1036
Country : US
Telephone Number : 833-328-8476
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2020
Last Update Date : 01/13/2026

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Directions to “ CAITLYN EMILIE PASSINO ” Practice Location

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