Provider Demographics
NPI:1689111551
Name:RENE-DARBOUZE, BARBARA (MSW, LGSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:RENE-DARBOUZE
Suffix:
Gender:F
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:HAVRE DE GRACE
Mailing Address - State:MD
Mailing Address - Zip Code:21078-3405
Mailing Address - Country:US
Mailing Address - Phone:443-526-6133
Mailing Address - Fax:443-526-6134
Practice Address - Street 1:400 LEWIS STREET
Practice Address - Street 2:
Practice Address - City:HAVRE DE GRACE
Practice Address - State:MD
Practice Address - Zip Code:21078
Practice Address - Country:US
Practice Address - Phone:443-526-6133
Practice Address - Fax:443-526-6134
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-30
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21483101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health