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NPI Code Detail

MEDICARE: CAITLIN KILGORE BCBA

MEDICARE:   CAITLIN  KILGORE  BCBA
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
11041C0700XClinical Social Worker
2103K00000XBehavior Analyst1-13-14629CO

General Provider Information

NPI Number : 1689983363
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAITLIN KILGORE BCBA
Provider Business Mailing Address
First Line : 2338 W ROYAL PALM RD STE J
Second Line :
City : PHOENIX
State : AZ
Zip : 85021-9339
Country : US
Telephone Number : 855-772-8847
Fax Number :
Provider Business Practice Location Address
First Line : 2338 W ROYAL PALM RD STE J
Second Line :
City : PHOENIX
State : AZ
Zip : 85021-9339
Country : US
Telephone Number : 884-785-5772
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2010
Last Update Date : 11/04/2024

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Directions to “ CAITLIN KILGORE BCBA” Practice Location

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