Provider Demographics
NPI:1073167128
Name:BARNES-OLSON, PARIS C
Entity Type:Individual
Prefix:
First Name:PARIS
Middle Name:C
Last Name:BARNES-OLSON
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 1:1700 WILLOW ST APT 8
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-4185
Mailing Address - Country:US
Mailing Address - Phone:907-687-4175
Mailing Address - Fax:
Practice Address - Street 1:1700 WILLOW ST APT 8
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-4185
Practice Address - Country:US
Practice Address - Phone:907-687-4175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-26
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician