Provider Demographics
NPI:1295023133
Name:O'CONNELL, CAROLYN DOREY (MS, BCBA)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:DOREY
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3788 HUDSON CT
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-7325
Mailing Address - Country:US
Mailing Address - Phone:239-784-4989
Mailing Address - Fax:
Practice Address - Street 1:3788 HUDSON CT
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-7325
Practice Address - Country:US
Practice Address - Phone:239-784-4989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-13
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-11-7957103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst