Individual
KAITLYN YOUNGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17B MARSHELLEN DR, BEAUFORT, SC 29902-6900
(843) 379-5655
(904) 538-0714
Mailing address
10175 FORTUNE PKWY UNIT 903, JACKSONVILLE, FL 32256-6755
(904) 538-0713
(904) 538-0714
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-90663
NC
Other
Enumeration date
06/24/2019
Last updated
06/24/2019
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