Provider Demographics
NPI:1225293665
Name:CAMP, CARRIE B (MA, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:B
Last Name:CAMP
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:MISS
Other - First Name:CARRIE
Other - Middle Name:B
Other - Last Name:HORTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6732 WALNUT HILLS DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7856
Mailing Address - Country:US
Mailing Address - Phone:615-772-3245
Mailing Address - Fax:
Practice Address - Street 1:6732 WALNUT HILLS DR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-7856
Practice Address - Country:US
Practice Address - Phone:615-772-3245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
TN1-09-5597103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst