Provider Demographics
NPI:1962212621
Name:BARONE, AUTUMN
Entity type:Individual
Prefix:
First Name:AUTUMN
Middle Name:
Last Name:BARONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 BEACH DR
Mailing Address - Street 2:
Mailing Address - City:VASSAR
Mailing Address - State:KS
Mailing Address - Zip Code:66543-9146
Mailing Address - Country:US
Mailing Address - Phone:785-219-2843
Mailing Address - Fax:
Practice Address - Street 1:3421 BEACH DR
Practice Address - Street 2:
Practice Address - City:VASSAR
Practice Address - State:KS
Practice Address - Zip Code:66543-9146
Practice Address - Country:US
Practice Address - Phone:785-219-2843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst