Provider Demographics
NPI:1780195297
Name:BARTON, AMANDA GRACE (EDS, NCSP, BCBA)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:GRACE
Last Name:BARTON
Suffix:
Gender:F
Credentials:EDS, NCSP, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 W 18TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-4707
Mailing Address - Country:US
Mailing Address - Phone:605-444-9505
Mailing Address - Fax:
Practice Address - Street 1:1020 W 18TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-4707
Practice Address - Country:US
Practice Address - Phone:605-444-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD003-ABA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst