Provider Demographics
NPI:1093316333
Name:DADISMAN, BARBARA J (RESPITE)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:DADISMAN
Suffix:
Gender:F
Credentials:RESPITE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 LUCAS RD
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:WV
Mailing Address - Zip Code:26354-8085
Mailing Address - Country:US
Mailing Address - Phone:304-265-2645
Mailing Address - Fax:
Practice Address - Street 1:364 PARRISH RUN RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:WV
Practice Address - Zip Code:26571-8097
Practice Address - Country:US
Practice Address - Phone:304-287-2122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant