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NPI Code Detail

MEDICARE: CARLA FAULKNER GARRETT BCBA

MEDICARE: CARLA FAULKNER GARRETT BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst2023-040AL
2106S00000XBehavior Technician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11-23-64709OTHERALBEHAVIOR ANALYST
2RBT-17-33878OTHERALBEHAVIOR ANALYST CERTIFICATION BOARD

General Provider Information

NPI Number : 1770070203
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLA FAULKNER GARRETT BCBA
Provider Business Mailing Address
First Line : 112 ADRIS PL
Second Line :
City : DOTHAN
State : AL
Zip : 36303-1997
Country : US
Telephone Number : 334-618-3302
Fax Number :
Provider Business Practice Location Address
First Line : 1018 S BRUNDIDGE ST
Second Line :
City : TROY
State : AL
Zip : 36081-3148
Country : US
Telephone Number : 334-618-3302
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2018
Last Update Date : 01/16/2024

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