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NPI Code Detail

MEDICARE: SAMANTHA LYNN BARRETT BCBA

MEDICARE: SAMANTHA LYNN BARRETT BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1629527585
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA LYNN BARRETT BCBA
Provider Business Mailing Address
First Line : 717 GREENWOOD DR
Second Line :
City : WHEATON
State : IL
Zip : 60189-6234
Country : US
Telephone Number : 630-222-5774
Fax Number :
Provider Business Practice Location Address
First Line : 1804 CENTRE POINT CIR STE 102
Second Line :
City : NAPERVILLE
State : IL
Zip : 60563-4849
Country : US
Telephone Number : 630-955-1940
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2016
Last Update Date : 01/21/2019

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