Provider Demographics
NPI:1811032154
Name:BARKER, DANA ALLISON X
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:ALLISON
Last Name:BARKER
Suffix:X
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 1:2077 CAPE HEATHER CIR
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-3503
Mailing Address - Country:US
Mailing Address - Phone:239-283-7222
Mailing Address - Fax:239-283-6306
Practice Address - Street 1:2077 CAPE HEATHER CIR
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-3503
Practice Address - Country:US
Practice Address - Phone:239-283-7222
Practice Address - Fax:239-283-6306
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL766710800Medicaid
FL811617200Medicaid