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General NPI Number Information
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NPI Number | 1114522604
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Entity Type | Individual
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Provider Name | CASSITA TRAMAINE CAIN
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Gender | Female
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Dates
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Enumeration Date | 12/02/2020
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Last Update Date | 12/02/2020
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Provider Practice Location Address
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Address Line | 2387 HUNTCREST WAY,
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-3004
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Country | US
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Telephone | 678-710-2324
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Fax |
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Provider Business Mailing Address
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Address Line | 2509 THOUSAND OAKS DR
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City | HARTSVILLE
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State | SC
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Zip | 29550-7696
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Country | US
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Telephone | 843-861-8890
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Fax |
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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 |
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License Number State |
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