MEDICARE: KAITLYN HOPE PARTIN

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	994	NC

General Provider Information

NPI Number	:	1619516721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLYN HOPE PARTIN

Provider Business Mailing Address
First Line	:	4401 BETHEL PARK DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27610-8403
Country	:	US
Telephone Number	:	919-612-7908
Fax Number	:

Provider Business Practice Location Address
First Line	:	3900 FAYETTEVILLE RD STE 100
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27603-3602
Country	:	US
Telephone Number	:	980-785-1113
Fax Number	:

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

Provider Enumeration Date	:	01/06/2020
Last Update Date	:	01/12/2026

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Directions to “ KAITLYN HOPE PARTIN ” Practice Location

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