Carrillo, Jacklyn

Carrillo, Jacklyn is an individual health care provider with primary practice located at 2021 Monroe St , Dearborn MI 48124-2926. She recently has 2 registered licenses in different health care specialties including Technologists, Technicians & Other Technical Service Providers / Technician, Other, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Carrillo, Jacklyn can be contacted via phone (517) 245-4777.

Contact Information

Primary practice address
2021 Monroe St Dearborn MI 48124-2926
Phone: (517) 245-4777
Fax: (517) 698-8223
Website:
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Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Technician, Other 247200000X
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X

Profile Details

NPI number 1700310729
LBN Legal business name Carrillo, Jacklyn
Credentials BCBA
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 17th, 2017
Last updated Aug 24th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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