Provider Demographics
NPI:1922689751
Name:BARRETT, WENDY (RBT)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:BARRETT
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:BARRETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RBT
Mailing Address - Street 1:130 DELTA PARK DR APT 14
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-3577
Mailing Address - Country:US
Mailing Address - Phone:704-472-9436
Mailing Address - Fax:
Practice Address - Street 1:2675 COURT DR # B
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-1478
Practice Address - Country:US
Practice Address - Phone:704-824-4999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician