Individual
KACI CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4487 FORBES BLVD # 4485, LANHAM, MD 20706-4354
(301) 429-2900
Mailing address
4487 FORBES BLVD # 4485, LANHAM, MD 20706-4354
(301) 429-2900
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-40382
NJ
106S00000X
Behavior Technician
RBT-16-25979
NJ
Other
Enumeration date
01/23/2018
Last updated
09/09/2022
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