Provider Demographics
NPI:1053448472
Name:BARROW, TEAH LARIE (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:TEAH
Middle Name:LARIE
Last Name:BARROW
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18540 OLALEE WAY
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-1403
Mailing Address - Country:US
Mailing Address - Phone:760-217-8220
Mailing Address - Fax:
Practice Address - Street 1:18245 US HIGHWAY 18 STE 6
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2217
Practice Address - Country:US
Practice Address - Phone:760-217-8220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27669106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA27669OtherMFC