Provider Demographics
NPI:1003506023
Name:CARO, OLIVIA DAVIS (BCABA)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:DAVIS
Last Name:CARO
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:ANNE
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14252 LADDERBACKED DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-5918
Mailing Address - Country:US
Mailing Address - Phone:804-241-5029
Mailing Address - Fax:
Practice Address - Street 1:14252 LADDERBACKED DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-5918
Practice Address - Country:US
Practice Address - Phone:804-241-5029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0-23-14391103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst