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NPI Code Detail

MEDICARE: CAITLIN LEE

MEDICARE: CAITLIN LEE
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1649086620
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAITLIN LEE
Provider Business Mailing Address
First Line : 5701 MARK IV PKWY STE 400
Second Line :
City : FORT WORTH
State : TX
Zip : 76131-3321
Country : US
Telephone Number : 682-350-8847
Fax Number :
Provider Business Practice Location Address
First Line : 5701 MARK IV PKWY STE 400
Second Line :
City : FORT WORTH
State : TX
Zip : 76131-3321
Country : US
Telephone Number : 682-350-8847
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2024
Last Update Date : 12/05/2024

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Directions to “ CAITLIN LEE ” Practice Location

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