Provider Demographics
NPI:1366008674
Name:COTTEN-BARKLEY, NIJA (BCBA)
Entity Type:Individual
Prefix:
First Name:NIJA
Middle Name:
Last Name:COTTEN-BARKLEY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:VANIJA
Other - Middle Name:
Other - Last Name:BARKLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:9000 SAVANNAH MAGNOLIA LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-5111
Mailing Address - Country:US
Mailing Address - Phone:708-743-6452
Mailing Address - Fax:
Practice Address - Street 1:6900 TAVISTOCK LAKES BLVD STE 400
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7593
Practice Address - Country:US
Practice Address - Phone:407-203-8509
Practice Address - Fax:407-203-8509
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-20-44659103K00000X
FL0-19-10660103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty