Provider Demographics
NPI:1568985422
Name:BARNETT, HAILEY BROOK (BCBA, MS)
Entity Type:Individual
Prefix:MRS
First Name:HAILEY
Middle Name:BROOK
Last Name:BARNETT
Suffix:
Gender:F
Credentials:BCBA, MS
Other - Prefix:MS
Other - First Name:HAILEY
Other - Middle Name:BROOK
Other - Last Name:MCCOLLUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA, MS
Mailing Address - Street 1:3021 MITFORD CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8175
Mailing Address - Country:US
Mailing Address - Phone:606-875-5599
Mailing Address - Fax:
Practice Address - Street 1:830 EASTERN BYP STE A6-A7
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2512
Practice Address - Country:US
Practice Address - Phone:859-353-5006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-24
Last Update Date:2017-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1-17-25654103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst