Provider Demographics
NPI:1023395811
Name:BUIE, BARBARA FAYE (PHD, GC-C, IDD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:FAYE
Last Name:BUIE
Suffix:
Gender:F
Credentials:PHD, GC-C, IDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2919 LEE DR SE
Mailing Address - Street 2:
Mailing Address - City:BOGUE CHITTO
Mailing Address - State:MS
Mailing Address - Zip Code:39629-9414
Mailing Address - Country:US
Mailing Address - Phone:601-754-1674
Mailing Address - Fax:601-734-6737
Practice Address - Street 1:2919 LEE DR SE
Practice Address - Street 2:
Practice Address - City:BOGUE CHITTO
Practice Address - State:MS
Practice Address - Zip Code:39629-9414
Practice Address - Country:US
Practice Address - Phone:601-754-1674
Practice Address - Fax:601-734-6737
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS136982101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health