Provider Demographics
NPI:1477763142
Name:ANDERSON, BARBARA EILEEN (MTBC)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:EILEEN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MTBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 DENNISON AVE
Mailing Address - Street 2:
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-6203
Mailing Address - Country:US
Mailing Address - Phone:651-482-9867
Mailing Address - Fax:
Practice Address - Street 1:194 DENNISON AVE
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-6203
Practice Address - Country:US
Practice Address - Phone:651-482-9867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN05630225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist