Healthcare Provider Details

I. General information

NPI: 1821450503
Provider Name (Legal Business Name): CAITLIN ELIZABETH ALLEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 MAPLE ST
SPRINGFIELD MA
01105-1864
US

IV. Provider business mailing address

110 MAPLE ST
SPRINGFIELD MA
01105-1864
US

V. Phone/Fax

Practice location:
  • Phone: 413-648-6348
  • Fax:
Mailing address:
  • Phone: 413-648-6348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLABA10001226
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: