Provider Demographics
NPI:1508010398
Name:BARKER, GALE ANNETTE (CDA)
Entity Type:Individual
Prefix:MRS
First Name:GALE
Middle Name:ANNETTE
Last Name:BARKER
Suffix:
Gender:F
Credentials:CDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 PINEHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:WINSLOW
Mailing Address - State:AR
Mailing Address - Zip Code:72959-2500
Mailing Address - Country:US
Mailing Address - Phone:479-634-2007
Mailing Address - Fax:479-634-2007
Practice Address - Street 1:178 PINEHAVEN DR
Practice Address - Street 2:
Practice Address - City:WINSLOW
Practice Address - State:AR
Practice Address - Zip Code:72959-2500
Practice Address - Country:US
Practice Address - Phone:479-634-2007
Practice Address - Fax:479-634-2007
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR12688305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization