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General NPI Number Information
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NPI Number | 1124840582
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Entity Type | Individual
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Provider Name | CAITLYN GRAY
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Gender | Female
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 5202 EASTPARK BLVD STE 100
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City | MADISON
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State | WI
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Zip | 53718-2151
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Country | US
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Telephone | 833-646-3222
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Fax |
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Provider Business Mailing Address
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Address Line | 117 S HAMILTON ST APT 305
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City | MADISON
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State | WI
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Zip | 53703-4400
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Country | US
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Telephone | 205-807-1043
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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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