Provider Demographics
NPI:1114594827
Name:ALBERDA, CARLA M (RBT)
Entity type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:M
Last Name:ALBERDA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1982
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73402
Mailing Address - Country:US
Mailing Address - Phone:580-513-3355
Mailing Address - Fax:
Practice Address - Street 1:307 4TH AVE SE
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401
Practice Address - Country:US
Practice Address - Phone:580-319-5770
Practice Address - Fax:580-319-7086
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician