Provider Demographics
NPI:1417355611
Name:NAZZARO, KARLINE ROSANNE (MED, BCBA)
Entity type:Individual
Prefix:MS
First Name:KARLINE
Middle Name:ROSANNE
Last Name:NAZZARO
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1499 S FEDERAL HWY UNIT 119
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-6074
Mailing Address - Country:US
Mailing Address - Phone:617-794-7479
Mailing Address - Fax:
Practice Address - Street 1:1499 S FEDERAL HWY UNIT 119
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-6074
Practice Address - Country:US
Practice Address - Phone:617-794-7479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-21
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1-13-13519103K00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst