Provider Demographics
NPI:1154902435
Name:MAPPA, CARLY (BCBA)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:
Last Name:MAPPA
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 ASPEN WOOD LN
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-3620
Mailing Address - Country:US
Mailing Address - Phone:203-362-7700
Mailing Address - Fax:
Practice Address - Street 1:14 FALCON DR
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:CT
Practice Address - Zip Code:06483-2354
Practice Address - Country:US
Practice Address - Phone:203-362-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-18
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst