Provider Demographics
NPI:1922580760
Name:GILL, CARRIE ELIZABETH (BCABA)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ELIZABETH
Last Name:GILL
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 1:63 HILLTOP RD
Mailing Address - Street 2:
Mailing Address - City:TOLLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06084-2915
Mailing Address - Country:US
Mailing Address - Phone:860-462-4565
Mailing Address - Fax:
Practice Address - Street 1:63 HILLTOP RD
Practice Address - Street 2:
Practice Address - City:TOLLAND
Practice Address - State:CT
Practice Address - Zip Code:06084-2915
Practice Address - Country:US
Practice Address - Phone:860-462-4565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst