Provider Demographics
NPI:1326235862
Name:BARRERA, RICARDO D (MA, PHD)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:D
Last Name:BARRERA
Suffix:
Gender:M
Credentials:MA, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 DEXTERDALE DR
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-9416
Mailing Address - Country:US
Mailing Address - Phone:401-884-4997
Mailing Address - Fax:
Practice Address - Street 1:4499 ACUSHNET AVE
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-4707
Practice Address - Country:US
Practice Address - Phone:508-995-6900
Practice Address - Fax:508-998-8131
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6363103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist