Provider Demographics
NPI:1558823229
Name:BARNES, ANYTRA ODAYA (MSED)
Entity Type:Individual
Prefix:
First Name:ANYTRA
Middle Name:ODAYA
Last Name:BARNES
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 ALBANY AVE APT 2H
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-2106
Mailing Address - Country:US
Mailing Address - Phone:347-721-0765
Mailing Address - Fax:
Practice Address - Street 1:193 ALBANY AVE APT 2H
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-2106
Practice Address - Country:US
Practice Address - Phone:347-721-0765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency