Provider Demographics
NPI:1841072873
Name:CARO, KRISTIE MARIE
Entity type:Individual
Prefix:MRS
First Name:KRISTIE
Middle Name:MARIE
Last Name:CARO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:KRISTIE
Other - Middle Name:MARIE
Other - Last Name:LINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 CABANA CAY CIR APT 1-223
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32413-4662
Mailing Address - Country:US
Mailing Address - Phone:850-774-7569
Mailing Address - Fax:
Practice Address - Street 1:100 CABANA CAY CIR APT 1-223
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32413-4662
Practice Address - Country:US
Practice Address - Phone:850-774-7569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician