Provider Demographics
NPI:1043099435
Name:KIRKPATRICK, KAILEY (BEHAVIOR TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:KAILEY
Middle Name:
Last Name:KIRKPATRICK
Suffix:
Gender:F
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 W CORBIN ST STE 204
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-2192
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:984-217-0009
Practice Address - Street 1:105 W CORBIN ST STE 204
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-2192
Practice Address - Country:US
Practice Address - Phone:919-742-0919
Practice Address - Fax:984-217-0009
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCRBT-15-04622106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician