Provider Demographics
NPI:1609021526
Name:TOUSSAINT-FOWLDS, BARBARA (LAC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:TOUSSAINT-FOWLDS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2106 ROBLYN AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-5023
Mailing Address - Country:US
Mailing Address - Phone:651-207-3019
Mailing Address - Fax:651-644-7162
Practice Address - Street 1:2106 ROBLYN AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-5023
Practice Address - Country:US
Practice Address - Phone:651-207-3019
Practice Address - Fax:651-644-7162
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1283171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist