Provider Demographics
NPI:1609042043
Name:KNEHER, BARBARA LYNNE (LRT)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:LYNNE
Last Name:KNEHER
Suffix:
Gender:F
Credentials:LRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 STELLER RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-9558
Mailing Address - Country:US
Mailing Address - Phone:910-455-5345
Mailing Address - Fax:910-455-5345
Practice Address - Street 1:313 STELLER RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-9558
Practice Address - Country:US
Practice Address - Phone:910-455-5345
Practice Address - Fax:910-455-5345
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC000966225800000X
101Y00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No174400000XOther Service ProvidersSpecialist