Provider Demographics
NPI:1356929814
Name:AUGLE, KAITLYN M (BCBA)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:M
Last Name:AUGLE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 N LINDA ST
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-3248
Mailing Address - Country:US
Mailing Address - Phone:219-682-8934
Mailing Address - Fax:
Practice Address - Street 1:442 SAND CREEK DR STE 101
Practice Address - Street 2:
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-1596
Practice Address - Country:US
Practice Address - Phone:219-359-3272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1-21-48234103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst