Provider Demographics
NPI:1518520626
Name:BARRY, RACHEL ERIN
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ERIN
Last Name:BARRY
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 1:111 RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-2431
Mailing Address - Country:US
Mailing Address - Phone:630-917-0308
Mailing Address - Fax:
Practice Address - Street 1:111 RIDGE LN
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-2431
Practice Address - Country:US
Practice Address - Phone:630-917-0308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-16
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician