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General NPI Number Information
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NPI Number | 1326465550
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Entity Type | Individual
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Provider Name | KAITLYN CLEARY
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Gender | Female
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Dates
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Enumeration Date | 03/26/2014
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 1809 WILLIAM ST
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-5236
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Country | US
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Telephone | 540-922-1110
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Fax | 775-392-1245
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Provider Business Mailing Address
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Address Line | 2423 S ORANGE AVE # 353
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City | ORLANDO
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State | FL
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Zip | 32806-4543
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Country | US
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Telephone | 540-922-1110
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Fax | 775-392-1245
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0134000070
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License Number State | VA
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