Provider Demographics
NPI:1316380728
Name:HADLEY, BARBARA JO (MA)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:JO
Last Name:HADLEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 BONFORTE BLVD
Mailing Address - Street 2:UNIT C
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81001-1679
Mailing Address - Country:US
Mailing Address - Phone:719-546-1300
Mailing Address - Fax:
Practice Address - Street 1:1624 BONFORTE BLVD
Practice Address - Street 2:UNIT C
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81001-1679
Practice Address - Country:US
Practice Address - Phone:719-546-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-16
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1407101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional