Provider Demographics
NPI:1689005829
Name:OCKERT, CAILIN MCCOLLOUGH (MS, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:CAILIN
Middle Name:MCCOLLOUGH
Last Name:OCKERT
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 1:10251 N 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051
Mailing Address - Country:US
Mailing Address - Phone:714-334-7077
Mailing Address - Fax:
Practice Address - Street 1:1430 E BASELINE RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1406
Practice Address - Country:US
Practice Address - Phone:602-926-7200
Practice Address - Fax:602-368-2730
Is Sole Proprietor?:No
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBA-98103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst