Provider Demographics
NPI:1558018143
Name:CARLIN, KYLIE ELIZABETH
Entity Type:Individual
Prefix:
First Name:KYLIE
Middle Name:ELIZABETH
Last Name:CARLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KYLIE
Other - Middle Name:ELIZABETH
Other - Last Name:HULL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1918 HIGHWAY 96 N
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62305-0073
Mailing Address - Country:US
Mailing Address - Phone:217-440-1797
Mailing Address - Fax:
Practice Address - Street 1:1918 HIGHWAY 96 N
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62305-0073
Practice Address - Country:US
Practice Address - Phone:217-440-1797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist