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NPI Code Detail

MEDICARE: CAILEY MICHAL KREITMAN

MEDICARE: CAILEY MICHAL KREITMAN
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
1103K00000XBehavior Analyst770NC
2103K00000XBehavior Analyst1-23-67976NC

General Provider Information

NPI Number : 1790361863
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAILEY MICHAL KREITMAN
Provider Business Mailing Address
First Line : 134 INFIELD CT
Second Line :
City : MOORESVILLE
State : NC
Zip : 28117-8026
Country : US
Telephone Number : 704-799-6824
Fax Number : 704-799-6825
Provider Business Practice Location Address
First Line : 2102 CAMBRIDGE BELTWAY DR STE E
Second Line :
City : CHARLOTTE
State : NC
Zip : 28273-4354
Country : US
Telephone Number : 704-799-6824
Fax Number : 704-799-6825
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2021
Last Update Date : 04/16/2024

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Directions to “ CAILEY MICHAL KREITMAN ” Practice Location

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