Provider Demographics
NPI:1861881286
Name:CARLIN, AMANDA (BCBA)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:CARLIN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:BOURGEOIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:300 PARK WEST DR
Mailing Address - Street 2:
Mailing Address - City:SCOTT
Mailing Address - State:LA
Mailing Address - Zip Code:70583-8911
Mailing Address - Country:US
Mailing Address - Phone:337-233-1167
Mailing Address - Fax:337-233-1168
Practice Address - Street 1:300 PARK WEST DR
Practice Address - Street 2:
Practice Address - City:SCOTT
Practice Address - State:LA
Practice Address - Zip Code:70583-8911
Practice Address - Country:US
Practice Address - Phone:337-233-1167
Practice Address - Fax:337-233-1168
Is Sole Proprietor?:No
Enumeration Date:2015-01-22
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst