Provider Demographics
NPI:1376979641
Name:BARNARD, COLLEEN BRIANNA (BA)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:BRIANNA
Last Name:BARNARD
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:BRIANNA
Other - Last Name:MACHENRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17103 HEART OF PALMS DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3510
Mailing Address - Country:US
Mailing Address - Phone:941-993-6768
Mailing Address - Fax:
Practice Address - Street 1:4301 N FEDERAL HWY
Practice Address - Street 2:SUITE 2 SOUTH
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-6519
Practice Address - Country:US
Practice Address - Phone:888-880-9270
Practice Address - Fax:954-342-0273
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist