Provider Demographics
NPI:1578720199
Name:BARKLEY, SANDY (MA)
Entity Type:Individual
Prefix:
First Name:SANDY
Middle Name:
Last Name:BARKLEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 MAIN ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-6049
Mailing Address - Country:US
Mailing Address - Phone:541-273-0709
Mailing Address - Fax:
Practice Address - Street 1:501 MAIN ST
Practice Address - Street 2:SUITE 305
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-6049
Practice Address - Country:US
Practice Address - Phone:541-273-0709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1534101YM0800X
CAMFC36175106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist