Provider Demographics
NPI:1710237110
Name:BARRETT, JOANNE MANUEL (MSED)
Entity Type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:MANUEL
Last Name:BARRETT
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:MS
Other - First Name:JOANNE
Other - Middle Name:MANUEL
Other - Last Name:JAUCIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSED
Mailing Address - Street 1:64 ERNST AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-4509
Mailing Address - Country:US
Mailing Address - Phone:973-338-7448
Mailing Address - Fax:
Practice Address - Street 1:64 ERNST AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-4509
Practice Address - Country:US
Practice Address - Phone:973-338-7448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY339120031174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist