Individual
MR. MICHAEL DEAN BARKER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCABA
Contact information
Practice address
401 BROADWAY AVE, PUEBLO, CO 81004-2127
(719) 425-7771
Mailing address
2285 FREMONT DR, CANON CITY, CO 81212-2533
(719) 431-2072
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-22-13926
CO
106S00000X
Behavior Technician
RBT-20-144415
CO
Other
Enumeration date
11/13/2020
Last updated
10/20/2022
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