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NPI Code Detail

MEDICARE: KAITLIN CARLOUGH

MEDICARE: KAITLIN CARLOUGH
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1770397317
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAITLIN CARLOUGH
Provider Business Mailing Address
First Line : 2075 RALPH STEPHENS RD
Second Line :
City : HOLLY SPRINGS
State : NC
Zip : 27540-8881
Country : US
Telephone Number : 704-780-4271
Fax Number :
Provider Business Practice Location Address
First Line : 2075 RALPH STEPHENS RD
Second Line :
City : HOLLY SPRINGS
State : NC
Zip : 27540-8881
Country : US
Telephone Number : 704-780-4271
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2025
Last Update Date : 02/04/2025

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Directions to “ KAITLIN CARLOUGH ” Practice Location

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