Individual
AMANDA CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
211 N PARKER DR, JANESVILLE, WI 53545-3021
(608) 662-9327
Mailing address
6225 SMITH AVE STE 1001A, BALTIMORE, MD 21209-3626
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1051
WI
Other
Enumeration date
12/09/2022
Last updated
12/09/2022
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