Individual
KAITLYN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
4105 N WALNUT ST, MUNCIE, IN 47303-5904
(765) 587-5244
Mailing address
4105 N WALNUT ST, MUNCIE, IN 47303-5904
(765) 587-5244
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-43483
IN
106S00000X
Behavior Technician
RBT-18-72669
IN
Other
Enumeration date
05/15/2020
Last updated
08/06/2020
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