Provider Demographics
NPI:1619110947
Name:KAIRYS, BARBARA R
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:R
Last Name:KAIRYS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:BARBARA
Other - Middle Name:R
Other - Last Name:POMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:5022 MAPLE GLEN PL
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-7181
Mailing Address - Country:US
Mailing Address - Phone:407-688-7032
Mailing Address - Fax:407-688-9739
Practice Address - Street 1:150 SPARTAN DR
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-3468
Practice Address - Country:US
Practice Address - Phone:407-331-8002
Practice Address - Fax:407-331-8659
Is Sole Proprietor?:No
Enumeration Date:2009-04-16
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW69401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical