Individual
CAITLIN AUSTIN MANGUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
166 A1A N, PONTE VEDRA BEACH, FL 32082-5701
(904) 434-6351
Mailing address
166 A1A N, PONTE VEDRA BEACH, FL 32082-5701
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
FL
106E00000X
Assistant Behavior Analyst
—
FL
106S00000X
Behavior Technician
—
—
Other
Enumeration date
12/26/2017
Last updated
10/03/2023
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