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NPI Code Detail

MEDICARE: KAITLYN CUNNINGHAM

MEDICARE: KAITLYN CUNNINGHAM
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
1106E00000XAssistant Behavior Analyst
2106S00000XBehavior Technician
3103K00000XBehavior Analyst1-23-68999GA

General Provider Information

NPI Number : 1780265686
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAITLYN CUNNINGHAM
Provider Business Mailing Address
First Line : 1329 PINE RIDGE DR
Second Line :
City : SAVANNAH
State : GA
Zip : 31406-8239
Country : US
Telephone Number : 706-955-3537
Fax Number :
Provider Business Practice Location Address
First Line : 506 N MAIN ST STE D
Second Line :
City : HINESVILLE
State : GA
Zip : 31313-2512
Country : US
Telephone Number : 912-312-7409
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2021
Last Update Date : 04/12/2024

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Directions to “ KAITLYN CUNNINGHAM ” Practice Location

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