Provider Demographics
NPI:1578295432
Name:CARTER, CAYLEE ANGELA (BCABA)
Entity Type:Individual
Prefix:
First Name:CAYLEE
Middle Name:ANGELA
Last Name:CARTER
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 E EDISON ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-3529
Mailing Address - Country:US
Mailing Address - Phone:480-252-9334
Mailing Address - Fax:
Practice Address - Street 1:2244 E PRINCE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-2002
Practice Address - Country:US
Practice Address - Phone:480-252-9334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0-22-13757103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst