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General NPI Number Information
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NPI Number | 1154899847
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Entity Type | Individual
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Provider Name | KARINA CARRERA BCBA
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Gender | Female
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Dates
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Enumeration Date | 11/11/2018
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Last Update Date | 11/11/2018
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Provider Practice Location Address
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Address Line | 5538 S KENNETH AVE
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City | CHICAGO
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State | IL
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Zip | 60629-4802
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Country | US
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Telephone | 312-237-0262
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Fax |
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Provider Business Mailing Address
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Address Line | 2549 WEST ST
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City | RIVER GROVE
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State | IL
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Zip | 60171-1625
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Country | US
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Telephone | 708-441-9412
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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