Provider Demographics
NPI:1912898552
Name:PALMER, KAITLYNNE SAPPHIRE
Entity type:Individual
Prefix:
First Name:KAITLYNNE
Middle Name:SAPPHIRE
Last Name:PALMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1050 SOUTHERN DR APT 1206
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-5639
Mailing Address - Country:US
Mailing Address - Phone:864-399-4302
Mailing Address - Fax:
Practice Address - Street 1:1050 SOUTHERN DR APT 1206
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-5639
Practice Address - Country:US
Practice Address - Phone:864-399-4302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty