Provider Demographics
NPI:1902197148
Name:MONTERO, CARLA (BCBA)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:MONTERO
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9561 E PLUM HARBOR WAY
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-6356
Mailing Address - Country:US
Mailing Address - Phone:954-296-7551
Mailing Address - Fax:
Practice Address - Street 1:9561 E PLUM HARBOR WAY
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-6356
Practice Address - Country:US
Practice Address - Phone:954-296-7551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-10-7306103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst