Provider Demographics
NPI:1730482001
Name:DEAN, BARBARA LOUISE (LMT)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:LOUISE
Last Name:DEAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 W. MAIN ST.
Mailing Address - Street 2:STE 1
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-2465
Mailing Address - Country:US
Mailing Address - Phone:605-718-5720
Mailing Address - Fax:605-718-5721
Practice Address - Street 1:2120 W. MAIN ST.
Practice Address - Street 2:STE 1
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-2465
Practice Address - Country:US
Practice Address - Phone:605-718-5720
Practice Address - Fax:605-718-5720
Is Sole Proprietor?:No
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD904225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist