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Individual

CARISSA CARTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
425 W BEECH ST, UNIT 954, SAN DIEGO, CA 92101-2955
(830) 613-5631
Mailing address
425 W BEECH ST, UNIT 954, SAN DIEGO, CA 92101-2955
(830) 613-5631

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-23451
CA

Other

Enumeration date
02/13/2017
Last updated
02/13/2017
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