Provider Demographics
NPI:1922794379
Name:BAREFOOT, CANDACE (BCBA, LBA)
Entity Type:Individual
Prefix:MS
First Name:CANDACE
Middle Name:
Last Name:BAREFOOT
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 CHESTNUT DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-5708
Mailing Address - Country:US
Mailing Address - Phone:469-400-1226
Mailing Address - Fax:
Practice Address - Street 1:2405 CHESTNUT DR
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-5708
Practice Address - Country:US
Practice Address - Phone:469-400-1226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3092103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst