Abby Carrillo, BCBA
Individual provider Active NPI Behavior Analyst · Verona, WI
NPI 1063986016 · NPPES record last updated Jan 13, 2019
Key facts
- NPI
- 1063986016
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 1-18-32901 (WI)
- Practice address
- 200 Enterprise Dr
Verona, WI 53593-9124 - Phone
- (608) 497-3230
- NPI assigned
- Jan 13, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Achieving Collaborative Treatment | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-18-32901 | WI | Yes |
Addresses
Primary practice location
200 Enterprise Dr
Verona, WI 53593-9124
Mailing address
200 Enterprise Dr
Verona, WI 53593-9124
Other providers in Verona, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.