Provider Demographics
NPI:1639643364
Name:BARBARA BARRY, A MARRIAGE AND FAMILY THERAPY PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:BARBARA BARRY, A MARRIAGE AND FAMILY THERAPY PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-567-8714
Mailing Address - Street 1:3770 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-3252
Mailing Address - Country:US
Mailing Address - Phone:208-473-1176
Mailing Address - Fax:
Practice Address - Street 1:3770 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-3252
Practice Address - Country:US
Practice Address - Phone:208-473-1176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty