Provider Demographics
NPI:1134548886
Name:CARLE, MATTHEW (BCBA)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:CARLE
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22210 OBAN DR
Mailing Address - Street 2:
Mailing Address - City:SPICEWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:78669-2203
Mailing Address - Country:US
Mailing Address - Phone:830-299-9093
Mailing Address - Fax:
Practice Address - Street 1:22210 OBAN DR
Practice Address - Street 2:
Practice Address - City:SPICEWOOD
Practice Address - State:TX
Practice Address - Zip Code:78669-2203
Practice Address - Country:US
Practice Address - Phone:830-299-9093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-14-15191103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst