Most Relevant Information
Provider Data
| NPI Number: | 1003456179 |
| Provider Name: | KAITLYN NYKOLE MCKINNON RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/07/2020 |
| Last Updated: | 01/07/2020 |
Provider Practice Location
34 N WASHINGTON ST
ARDMORE
OK
734017013
Practice Location Phone/Fax
| Phone: | 5806703117 |
| Fax: |
Provider Mailing Location
41247 HIGHWAY 29
WYNNEWOOD
OK
730989116
Provider Mailing Phone/Fax
| Phone: | 5806703117 |
| Fax: |