Provider Demographics
NPI:1285171496
Name:BARTON, SHANNON (BCBA)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
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 1:10727 S PRESERVE WAY
Mailing Address - Street 2:APT. 207
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-6527
Mailing Address - Country:US
Mailing Address - Phone:775-354-6606
Mailing Address - Fax:
Practice Address - Street 1:10727 S PRESERVE WAY
Practice Address - Street 2:APT. 207
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-6527
Practice Address - Country:US
Practice Address - Phone:775-354-6606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst