Individual
CAITLYN DORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
328 GLEN ST, SUMMERVILLE, SC 29483-4653
(843) 460-2605
Mailing address
3590 MARY ADER AVE APT 1222, CHARLESTON, SC 29414-5793
(803) 606-6341
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-397289
SC
Other
Enumeration date
12/04/2024
Last updated
12/04/2024
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