Provider Demographics
NPI:1851966311
Name:BARKLEY, ANTOINETTE LAKETA
Entity Type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:LAKETA
Last Name:BARKLEY
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 1:645 HOWE AVE STE 1008
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-4955
Mailing Address - Country:US
Mailing Address - Phone:330-798-2596
Mailing Address - Fax:
Practice Address - Street 1:645 HOWE AVE STE 1008
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-4955
Practice Address - Country:US
Practice Address - Phone:330-798-2596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide