Gordon, Kaitlyn

Gordon, Kaitlyn is an individual health care provider with primary practice located at 1301 Museum Rd , Conway AR 72032-4739. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavior Technician, Behavioral Health & Social Service Providers / Assistant Behavior Analyst. Behavioral Health & Social Service Providers / Assistant Behavior Analyst is her primary health care specialty. Gordon, Kaitlyn can be contacted via phone (501) 358-6535.

Contact Information

Primary practice address
1301 Museum Rd Conway AR 72032-4739
Phone: (501) 358-6535
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X Arkansas
Behavioral Health & Social Service Providers / Assistant Behavior Analyst 106E00000X 0-22-13843 Arkansas

Profile Details

NPI number 1255980199
LBN Legal business name Gordon, Kaitlyn
Credentials BCABA
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 4th, 2019
Last updated Jul 28th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255980199 NPPES
Arkansas MEDICAID 1255980199

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