Provider Demographics
NPI:1760252431
Name:BARBER, DAWN ANTIONETTE
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:ANTIONETTE
Last Name:BARBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:ANTIONETTE
Other - Last Name:BARBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NELSON
Mailing Address - Street 1:3713 W MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-2931
Mailing Address - Country:US
Mailing Address - Phone:144-380-6219
Mailing Address - Fax:
Practice Address - Street 1:3713 W MULBERRY ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-2931
Practice Address - Country:US
Practice Address - Phone:144-380-6219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3420101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)