Provider Demographics
NPI:1417773268
Name:BYE-MCCLESKEY, CAITLEIN NICHOLE
Entity type:Individual
Prefix:
First Name:CAITLEIN
Middle Name:NICHOLE
Last Name:BYE-MCCLESKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 LOMA DEL ORO
Mailing Address - Street 2:
Mailing Address - City:CORRALES
Mailing Address - State:NM
Mailing Address - Zip Code:87048-6938
Mailing Address - Country:US
Mailing Address - Phone:505-900-1588
Mailing Address - Fax:
Practice Address - Street 1:169 LOMA DEL ORO
Practice Address - Street 2:
Practice Address - City:CORRALES
Practice Address - State:NM
Practice Address - Zip Code:87048-6938
Practice Address - Country:US
Practice Address - Phone:505-900-1588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician