Provider Demographics
NPI:1003389123
Name:BARAL, HEATHER R
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:R
Last Name:BARAL
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:CMR 405 BOX 2908
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09034-0030
Mailing Address - Country:US
Mailing Address - Phone:160-209-0423
Mailing Address - Fax:
Practice Address - Street 1:UNIT 23746
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09034-3746
Practice Address - Country:US
Practice Address - Phone:160-209-0423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-11
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099244221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical