Provider Demographics
NPI:1255533303
Name:MARTIN, CAITLYN (PSYCH)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PSYCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 NEW LINDEN HILL RD
Mailing Address - Street 2:RED CLAY CONSOLIDATED SCHOOL DISTRICT
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-2930
Mailing Address - Country:US
Mailing Address - Phone:302-552-3796
Mailing Address - Fax:
Practice Address - Street 1:4550 NEW LINDEN HILL RD
Practice Address - Street 2:RED CLAY CONSOLIDATED SCHOOL DISTRICT
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-2930
Practice Address - Country:US
Practice Address - Phone:302-552-3796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE24608103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool