Provider Demographics
NPI:1639642861
Name:BARNES, EMILY (IBCLC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 N KENNETH PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-2944
Mailing Address - Country:US
Mailing Address - Phone:480-528-5891
Mailing Address - Fax:
Practice Address - Street 1:285 N KENNETH PL
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-2944
Practice Address - Country:US
Practice Address - Phone:480-528-5891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-151671174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN