Provider Demographics
NPI:1801394697
Name:BARSALONA, HEATHER (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:BARSALONA
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:O'BRIEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, BCBA
Mailing Address - Street 1:3301 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-7721
Mailing Address - Country:US
Mailing Address - Phone:954-262-7117
Mailing Address - Fax:
Practice Address - Street 1:7600 SW 36TH ST
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-1902
Practice Address - Country:US
Practice Address - Phone:954-262-7117
Practice Address - Fax:954-262-3744
Is Sole Proprietor?:No
Enumeration Date:2018-01-26
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-07-3887103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst