Provider Demographics
NPI:1407148679
Name:CARPENTIERI, MICHELLE (BCBA, LBA-MO)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:CARPENTIERI
Suffix:
Gender:F
Credentials:BCBA, LBA-MO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4006 N 31ST ST
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-1373
Mailing Address - Country:US
Mailing Address - Phone:816-294-7618
Mailing Address - Fax:
Practice Address - Street 1:4006 N 31ST ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-1373
Practice Address - Country:US
Practice Address - Phone:816-294-7618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-06
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst