Provider Demographics
NPI:1699343053
Name:CAOLA, KHRISTINE (MA, BCBA)
Entity type:Individual
Prefix:
First Name:KHRISTINE
Middle Name:
Last Name:CAOLA
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 SUNSET LN
Mailing Address - Street 2:
Mailing Address - City:MANTOLOKING
Mailing Address - State:NJ
Mailing Address - Zip Code:08738-1410
Mailing Address - Country:US
Mailing Address - Phone:732-674-3506
Mailing Address - Fax:
Practice Address - Street 1:139 SUNSET LN
Practice Address - Street 2:
Practice Address - City:MANTOLOKING
Practice Address - State:NJ
Practice Address - Zip Code:08738-1410
Practice Address - Country:US
Practice Address - Phone:732-674-3506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst