Carly Kavanaugh
NPI #1073482592 in Jefferson City, Missouri
Provider Information
- NPI Number
- 1073482592
- Entity Type
- Individual
- Name
- Carly Kavanaugh
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Behavior Technician
- Enumeration Date
- Nov 3, 2025
- Last Updated
- Nov 3, 2025
Practice Location
- Address
- 1600 SOUTHWEST BLVD
- City
- Jefferson City
- State
- Missouri
- ZIP Code
- 65109-2455
- Phone
- (888) 515-1793
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Technician |
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