Provider Demographics
NPI:1790347938
Name:CRAIG, KALEIGH
Entity Type:Individual
Prefix:
First Name:KALEIGH
Middle Name:
Last Name:CRAIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 ROCKWAY AVE UNIT 309
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02188-4018
Mailing Address - Country:US
Mailing Address - Phone:603-913-5303
Mailing Address - Fax:
Practice Address - Street 1:35 ROCKWAY AVE UNIT 309
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02188-4018
Practice Address - Country:US
Practice Address - Phone:603-913-5303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician