Basic Information
| Provider Information | |||||||||
| NPI: | 1659993707 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARRETT | ||||||||
| FirstName: | HAILEE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 685 CITADEL DR E STE 345 | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809095326 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9403687105 | ||||||||
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| Practice Location | |||||||||
| Address1: | 685 CITADEL DR E STE 345 | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809095326 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9403687105 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2020 | ||||||||
| LastUpdateDate: | 09/09/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | RBT-20-115585 | N | 103K00000X | 1-21-52802 | CO | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.