Provider Demographics
NPI:1174826861
Name:ELZOHAIRY, BARBARA LOUISE (MA RN)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:LOUISE
Last Name:ELZOHAIRY
Suffix:
Gender:F
Credentials:MA RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:394 RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:ST JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819-1600
Mailing Address - Country:US
Mailing Address - Phone:802-535-2033
Mailing Address - Fax:
Practice Address - Street 1:394 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:ST JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819-1600
Practice Address - Country:US
Practice Address - Phone:802-535-2033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-18
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT097.0000728101YM0800X
VT026.0022700163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health