Provider Demographics
NPI:1275329138
Name:NARDUCCI, KAITLYN LANDIS
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:LANDIS
Last Name:NARDUCCI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 SWAN LN
Mailing Address - Street 2:
Mailing Address - City:IVYLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18974-2867
Mailing Address - Country:US
Mailing Address - Phone:717-440-4303
Mailing Address - Fax:
Practice Address - Street 1:13 SWAN LN
Practice Address - Street 2:
Practice Address - City:IVYLAND
Practice Address - State:PA
Practice Address - Zip Code:18974-2867
Practice Address - Country:US
Practice Address - Phone:717-440-4303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAPC001158101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional