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Individual

KAITLYN FUGATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
3568 GERAGHTY AVE, FAIRBANKS, AK 99709-4701
(907) 374-7001
Mailing address
5067 CREEKSIDE TRAIL, SARASOTA, FL 34243
(762) 359-0003

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
106S00000X
Behavior Technician

Other

Enumeration date
08/12/2018
Last updated
08/20/2021
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