MEDICARE: KAITLYN GIANNINI BCBA, LBS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst		PA

General Provider Information

NPI Number	:	1376056994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLYN GIANNINI BCBA, LBS

Provider Business Mailing Address
First Line	:	1285 E HORSESHOE AVE
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85296-1911
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2577 W TOWNSHIP LINE RD
Second Line	:
City	:	EAGLEVILLE
State	:	PA
Zip	:	19403-4635
Country	:	US
Telephone Number	:	407-409-0489
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2017
Last Update Date	:	12/01/2025

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