Provider Demographics
NPI:1588923056
Name:MINNEY, CAITLIN SUZANNE (BCBA)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:SUZANNE
Last Name:MINNEY
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 1:19222 COUNTY ROAD 4108
Mailing Address - Street 2:
Mailing Address - City:LINDALE
Mailing Address - State:TX
Mailing Address - Zip Code:75771-6170
Mailing Address - Country:US
Mailing Address - Phone:443-655-8075
Mailing Address - Fax:
Practice Address - Street 1:9545 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-1438
Practice Address - Country:US
Practice Address - Phone:202-420-8359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst