Provider Demographics
NPI:1679781223
Name:BARRE, ANGELA
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:
Last Name:BARRE
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 1:108 SAVANNA DR
Mailing Address - Street 2:
Mailing Address - City:LULING
Mailing Address - State:LA
Mailing Address - Zip Code:70070-3207
Mailing Address - Country:US
Mailing Address - Phone:504-390-1601
Mailing Address - Fax:
Practice Address - Street 1:407 HONEYSUCKLE DR
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:LA
Practice Address - Zip Code:70079-2196
Practice Address - Country:US
Practice Address - Phone:985-725-0288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA04446225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist