Healthcare Provider Details

I. General information

NPI: 1164062493
Provider Name (Legal Business Name): ANNEMARIE CATHERINE BARTER BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANNEMARIE CATHERINE LADING BCBA

II. Dates (important events)

Enumeration Date: 01/15/2020
Last Update Date: 01/15/2020
Certification Date: 01/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 S. MILWAUKEE AVE SUITE 235
WHEELING IL
60090
US

IV. Provider business mailing address

401 S. MILWAUKEE AVE SUITE 235
WHEELING IL
60090
US

V. Phone/Fax

Practice location:
  • Phone: 847-465-9556
  • Fax: 847-465-9621
Mailing address:
  • Phone: 847-465-9556
  • Fax: 847-465-9621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: