Provider Demographics
NPI:1740737386
Name:BARRETT, HARLEY
Entity Type:Individual
Prefix:
First Name:HARLEY
Middle Name:
Last Name:BARRETT
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:PO BOX 46
Mailing Address - Street 2:HIGH HOPES
Mailing Address - City:ELBERTA
Mailing Address - State:AL
Mailing Address - Zip Code:36530
Mailing Address - Country:US
Mailing Address - Phone:251-986-7007
Mailing Address - Fax:
Practice Address - Street 1:12786 ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:ELBERTA
Practice Address - State:AL
Practice Address - Zip Code:36530-2698
Practice Address - Country:US
Practice Address - Phone:251-986-7007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst