Provider Demographics
NPI:1003384173
Name:BARRETT, INDIA C (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:INDIA
Middle Name:C
Last Name:BARRETT
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MRS
Other - First Name:INDIA
Other - Middle Name:CAMIEL
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT
Mailing Address - Street 1:959 17TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-1984
Mailing Address - Country:US
Mailing Address - Phone:678-949-1811
Mailing Address - Fax:
Practice Address - Street 1:1110 13TH ST STE D
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-2246
Practice Address - Country:US
Practice Address - Phone:706-780-1704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA12368239103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst