Individual
CASEY CAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1297 PROFESSIONAL DR STE 101B, MYRTLE BEACH, SC 29577-5713
(910) 390-6635
(888) 510-1019
Mailing address
3020I PROSPERITY CHURCH RD # 247, CHARLOTTE, NC 28269-8112
(910) 390-6635
(888) 510-1019
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
05/11/2018
Last updated
05/20/2022
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