Provider Demographics
NPI:1902209570
Name:JENKINS, KAITLYN (MED, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:KAITLYN
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:JENKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED, BCBA
Mailing Address - Street 1:8180 SIEGEN LN
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-1914
Mailing Address - Country:US
Mailing Address - Phone:225-757-8002
Mailing Address - Fax:
Practice Address - Street 1:8180 SIEGEN LN
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-1914
Practice Address - Country:US
Practice Address - Phone:225-757-8002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-26
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst