Individual
KAITLYN DOMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
165 KIRTS BLVD STE 500, TROY, MI 48084-5214
(248) 486-3636
Mailing address
165 KIRTS BLVD STE 500, TROY, MI 48084-5214
(248) 486-3636
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
7401000460
MI
106S00000X
Behavior Technician
—
—
Other
Enumeration date
09/28/2016
Last updated
03/01/2022
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