Provider Demographics
NPI:1821547993
Name:BARROS, HOLLY (BCBA)
Entity Type:Individual
Prefix:MISS
First Name:HOLLY
Middle Name:
Last Name:BARROS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CRESCENT ST
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-1806
Mailing Address - Country:US
Mailing Address - Phone:603-502-0605
Mailing Address - Fax:603-504-3355
Practice Address - Street 1:8 CRESCENT ST
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-1806
Practice Address - Country:US
Practice Address - Phone:603-502-0605
Practice Address - Fax:603-504-3355
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-29
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1-10-7854103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst