Provider Demographics
NPI:1356502983
Name:FLAHERTY, BARBARA JEAN
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:JEAN
Last Name:FLAHERTY
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 1:951 CATALINA WAY
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55024-8413
Mailing Address - Country:US
Mailing Address - Phone:612-385-2027
Mailing Address - Fax:
Practice Address - Street 1:109 ELM ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55024-1048
Practice Address - Country:US
Practice Address - Phone:651-463-8555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist