Provider Demographics
NPI:1568209385
Name:ENGEL, CARA BRIANNE (RBT)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:BRIANNE
Last Name:ENGEL
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:BRIANNE
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:264 BIG BUCK TRL
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:GA
Mailing Address - Zip Code:30233-6628
Mailing Address - Country:US
Mailing Address - Phone:470-261-5053
Mailing Address - Fax:
Practice Address - Street 1:264 BIG BUCK TRL
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:GA
Practice Address - Zip Code:30233-6628
Practice Address - Country:US
Practice Address - Phone:470-261-5053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARBT-24-322790106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician