Provider Demographics
NPI:1346029857
Name:BARR, TRACY
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:BARR
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 1:609 BRIGHT MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3220
Mailing Address - Country:US
Mailing Address - Phone:240-418-2158
Mailing Address - Fax:
Practice Address - Street 1:609 BRIGHT MEADOW DR
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-3220
Practice Address - Country:US
Practice Address - Phone:240-418-2158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD305511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical