Provider Demographics
NPI:1265844526
Name:BARNES, PRECIOUS (ATC, MS, ART)
Entity Type:Individual
Prefix:
First Name:PRECIOUS
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:ATC, MS, ART
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 N IMBODEN ST APT 401
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-5498
Mailing Address - Country:US
Mailing Address - Phone:757-343-7427
Mailing Address - Fax:
Practice Address - Street 1:1301 POTOMAC SCHOOL RD
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-2350
Practice Address - Country:US
Practice Address - Phone:703-356-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-21
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA012001937OtherCOMMONWEALTH OF VIRGINIA, DEPARTMENT OF HEALTH PROFESSIONS