Provider Demographics
NPI:1558069120
Name:BARSOUM, NEVERT (BT)
Entity Type:Individual
Prefix:
First Name:NEVERT
Middle Name:
Last Name:BARSOUM
Suffix:
Gender:F
Credentials:BT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12093 REGAL CT W
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-5764
Mailing Address - Country:US
Mailing Address - Phone:561-543-5645
Mailing Address - Fax:
Practice Address - Street 1:1925 BIRKDALE DR
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-5809
Practice Address - Country:US
Practice Address - Phone:954-552-6668
Practice Address - Fax:954-206-5584
Is Sole Proprietor?:No
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician