Provider Demographics
NPI:1801060009
Name:AGNELLO, BARBARA (BCBA)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:AGNELLO
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 1:3007 STERLING CT
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29707-7832
Mailing Address - Country:US
Mailing Address - Phone:201-214-1534
Mailing Address - Fax:
Practice Address - Street 1:3007 STERLING CT
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29707-7832
Practice Address - Country:US
Practice Address - Phone:201-214-1534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041889103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst