Provider Demographics
NPI:1356647010
Name:BARNETT, SARA MICHELLE (BA, MED, PSRS)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:MICHELLE
Last Name:BARNETT
Suffix:
Gender:F
Credentials:BA, MED, PSRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 516
Mailing Address - Street 2:
Mailing Address - City:ANTLERS
Mailing Address - State:OK
Mailing Address - Zip Code:74523-0516
Mailing Address - Country:US
Mailing Address - Phone:580-298-5779
Mailing Address - Fax:580-298-6699
Practice Address - Street 1:301 N HIGH ST
Practice Address - Street 2:
Practice Address - City:ANTLERS
Practice Address - State:OK
Practice Address - Zip Code:74523-2238
Practice Address - Country:US
Practice Address - Phone:580-298-5779
Practice Address - Fax:580-298-6699
Is Sole Proprietor?:No
Enumeration Date:2011-01-28
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst