Provider Demographics
NPI:1972177202
Name:LYTLE, CARI (MS, RBAI)
Entity Type:Individual
Prefix:
First Name:CARI
Middle Name:
Last Name:LYTLE
Suffix:
Gender:F
Credentials:MS, RBAI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 DARLENE LN APT 338
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-1102
Mailing Address - Country:US
Mailing Address - Phone:406-868-5407
Mailing Address - Fax:
Practice Address - Street 1:219 42ND ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97478-5937
Practice Address - Country:US
Practice Address - Phone:541-224-6987
Practice Address - Fax:541-225-4628
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORABA-B-10232844103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst