Healthcare Provider Details

I. General information

NPI: 1588247274
Provider Name (Legal Business Name): KAITLYN ENGLISH RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2021
Last Update Date: 04/30/2021
Certification Date: 04/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 DAVIS DR
MERRITT ISLAND FL
32952-5933
US

IV. Provider business mailing address

21757 FORT CHRISTMAS RD
CHRISTMAS FL
32709-9460
US

V. Phone/Fax

Practice location:
  • Phone: 407-920-5346
  • Fax: 407-960-3009
Mailing address:
  • Phone: 407-274-1728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: