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General NPI Number Information
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NPI Number | 1003310962
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Entity Type | Individual
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Provider Name | KAITLYN MOURO GREER BCBA
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Gender | Female
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Dates
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Enumeration Date | 03/23/2018
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Last Update Date | 10/12/2022
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Provider Practice Location Address
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Address Line | 3401 COLONIAL DR
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City | COLUMBIA
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State | SC
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Zip | 29203-6934
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Country | US
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Telephone | 817-874-5812
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Fax |
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Provider Business Mailing Address
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Address Line | 3401 COLONIAL DR
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City | COLUMBIA
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State | SC
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Zip | 29203-6934
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Country | US
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Telephone | 803-216-1089
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Fax | 803-339-1907
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-20-43864
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License Number State |
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