Provider Demographics
NPI:1609429117
Name:BARNHOUSE, CODI LEA
Entity Type:Individual
Prefix:
First Name:CODI
Middle Name:LEA
Last Name:BARNHOUSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1612 SUPERIOR AVE
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-3120
Mailing Address - Country:US
Mailing Address - Phone:740-868-9305
Mailing Address - Fax:
Practice Address - Street 1:1400 BRANDYWINE BLVD
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1083
Practice Address - Country:US
Practice Address - Phone:740-212-6458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.024149225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist