Provider Demographics
NPI:1861501843
Name:WIREBAUGH, BARBARA ANN (LISW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:WIREBAUGH
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:ANN
Other - Last Name:BLAMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 722
Mailing Address - Street 2:
Mailing Address - City:BUCYRUS
Mailing Address - State:OH
Mailing Address - Zip Code:44820-0722
Mailing Address - Country:US
Mailing Address - Phone:419-569-6229
Mailing Address - Fax:
Practice Address - Street 1:1092 MARTHA AVE
Practice Address - Street 2:
Practice Address - City:BUCYRUS
Practice Address - State:OH
Practice Address - Zip Code:44820-3045
Practice Address - Country:US
Practice Address - Phone:419-569-6229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI102271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical