Provider Demographics
NPI:1831724772
Name:BUETOW-MCFARLAND, CAROLYNANNE (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:CAROLYNANNE
Middle Name:
Last Name:BUETOW-MCFARLAND
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:CARLY
Other - Middle Name:
Other - Last Name:BUETOW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BCBA, LBA
Mailing Address - Street 1:75100 MEDITERRANEAN
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-9069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:75100 MEDITERRANEAN
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-9069
Practice Address - Country:US
Practice Address - Phone:760-837-0033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-11
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-20-41636103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst