Provider Demographics
NPI:1740631225
Name:SCHWARTZ, MIHAELA CALBOREANU (BCBA)
Entity type:Individual
Prefix:
First Name:MIHAELA
Middle Name:CALBOREANU
Last Name:SCHWARTZ
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 1:958 TERRACESIDE CIR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-6134
Mailing Address - Country:US
Mailing Address - Phone:910-818-8418
Mailing Address - Fax:
Practice Address - Street 1:3337 MELISSA LN
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042-6395
Practice Address - Country:US
Practice Address - Phone:910-818-8418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1-16-22637103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst