Provider Demographics
NPI:1306419627
Name:BARRERA REYES, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:BARRERA REYES
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 1:5804 JAMESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-3256
Mailing Address - Country:US
Mailing Address - Phone:301-254-3237
Mailing Address - Fax:
Practice Address - Street 1:5804 JAMESTOWN RD
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-3256
Practice Address - Country:US
Practice Address - Phone:301-254-3237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD5F34B3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant