Provider Demographics
NPI:1508574294
Name:BURNETT, JOANNA (MA, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:BURNETT
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:
Other - Last Name:SCHUMACHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, BCBA, LBA
Mailing Address - Street 1:700 E RODEO RD APT 124
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-6459
Mailing Address - Country:US
Mailing Address - Phone:612-223-1512
Mailing Address - Fax:
Practice Address - Street 1:2024 E FLORENCE BLVD
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-5402
Practice Address - Country:US
Practice Address - Phone:520-494-3773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-10
Last Update Date:2023-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst