Provider Demographics
NPI:1073364121
Name:BARROW, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:BARROW
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 1:1087 HARBOR DR STE A
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-3609
Mailing Address - Country:US
Mailing Address - Phone:803-760-5611
Mailing Address - Fax:803-888-4064
Practice Address - Street 1:1087 HARBOR DR STE A
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-3609
Practice Address - Country:US
Practice Address - Phone:803-760-5611
Practice Address - Fax:803-888-4064
Is Sole Proprietor?:No
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician