Healthcare Provider Details

I. General information

NPI: 1013583590
Provider Name (Legal Business Name): CAITLIN SYKORA BCBA/LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2021
Last Update Date: 06/03/2021
Certification Date: 06/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2205 S BAGDAD RD
LEANDER TX
78641-2311
US

IV. Provider business mailing address

2800 E WHITESTONE BLVD
CEDAR PARK TX
78613-7273
US

V. Phone/Fax

Practice location:
  • Phone: 512-986-7625
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2555
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-18-31549
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: