Provider Demographics
NPI:1740622364
Name:BARTON, NICOLE A (BCBA)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:A
Last Name:BARTON
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 1:8817 W LOMA LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85345-2560
Mailing Address - Country:US
Mailing Address - Phone:602-821-2310
Mailing Address - Fax:
Practice Address - Street 1:8817 W LOMA LN
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-2560
Practice Address - Country:US
Practice Address - Phone:602-821-2310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst