Provider Demographics
NPI:1093070229
Name:WILLIAMS-CAMPBELL, CARRIE ELIZABETH (MS BCBA)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:ELIZABETH
Last Name:WILLIAMS-CAMPBELL
Suffix:
Gender:F
Credentials:MS BCBA
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:ELIZABETH
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18511 BANDELIER DR
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-5897
Mailing Address - Country:US
Mailing Address - Phone:704-591-0139
Mailing Address - Fax:
Practice Address - Street 1:3403 GARDEN VILLA LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-6915
Practice Address - Country:US
Practice Address - Phone:704-591-0139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-12-12193103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst