Provider Demographics
NPI:1073648242
Name:BARNETT, CHARLOTTE ANN
Entity Type:Individual
Prefix:MS
First Name:CHARLOTTE
Middle Name:ANN
Last Name:BARNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CHARLOTTE
Other - Middle Name:ANN
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:750 W CURLEW LAKE RD
Mailing Address - Street 2:
Mailing Address - City:REPUBLIC
Mailing Address - State:WA
Mailing Address - Zip Code:99166-9717
Mailing Address - Country:US
Mailing Address - Phone:509-775-3986
Mailing Address - Fax:
Practice Address - Street 1:42 KLONDIKE RD
Practice Address - Street 2:
Practice Address - City:REPUBLIC
Practice Address - State:WA
Practice Address - Zip Code:99166-9701
Practice Address - Country:US
Practice Address - Phone:509-775-3341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00056546101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health