Provider Demographics
NPI:1104418706
Name:BARNETTE, CASSIE (RBT)
Entity type:Individual
Prefix:
First Name:CASSIE
Middle Name:
Last Name:BARNETTE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7075 N HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32927-5216
Mailing Address - Country:US
Mailing Address - Phone:321-888-3020
Mailing Address - Fax:661-263-4584
Practice Address - Street 1:1737 N CLYDE MORRIS BLVD STE 140
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-5534
Practice Address - Country:US
Practice Address - Phone:321-888-3020
Practice Address - Fax:661-263-4584
Is Sole Proprietor?:No
Enumeration Date:2021-02-05
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INRBT-19-106910106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician