Provider Demographics
NPI:1306442876
Name:BARCLAY, STEPHANIE (BCBA)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:
Last Name:BARCLAY
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 1:36 WILDFLOWER LN
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:VT
Mailing Address - Zip Code:05674-9470
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:36 WILDFLOWER LN
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:VT
Practice Address - Zip Code:05674-9470
Practice Address - Country:US
Practice Address - Phone:802-522-5386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT1-18-29905103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst