Provider Demographics
NPI:1063994432
Name:HOLMES, KAITLYNN ELIZABETH (MA, BCBA, LBA)
Entity type:Individual
Prefix:MISS
First Name:KAITLYNN
Middle Name:ELIZABETH
Last Name:HOLMES
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:MRS
Other - First Name:KAITLYNN
Other - Middle Name:ELIZABETH
Other - Last Name:GINGRAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, BCBA
Mailing Address - Street 1:150 LONDON RD
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:CT
Mailing Address - Zip Code:06248-1031
Mailing Address - Country:US
Mailing Address - Phone:860-336-7496
Mailing Address - Fax:
Practice Address - Street 1:5420 BARBER MILL RD
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-7260
Practice Address - Country:US
Practice Address - Phone:919-484-3144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-03
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1012103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst