Provider Demographics
NPI:1033194840
Name:PARRY, BARBARA (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:PARRY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 370241
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89137-0241
Mailing Address - Country:US
Mailing Address - Phone:702-220-7633
Mailing Address - Fax:702-240-8052
Practice Address - Street 1:8240 W CHARLESTON BLVD
Practice Address - Street 2:#4
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-9088
Practice Address - Country:US
Practice Address - Phone:702-220-7633
Practice Address - Fax:702-240-8052
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPHD284103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002602070Medicaid
NVR26470Medicare UPIN
NVPHD284Medicare ID - Type Unspecified