Provider Demographics
NPI:1881829307
Name:BARRON, JUSTINE MARIE (MS)
Entity Type:Individual
Prefix:MRS
First Name:JUSTINE
Middle Name:MARIE
Last Name:BARRON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JUSTINE
Other - Middle Name:MARIE
Other - Last Name:BUCHANAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:JUSTINE BARRON
Mailing Address - Street 1:2610 BERMUDA LAKE DR
Mailing Address - Street 2:APT. 202
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33510
Mailing Address - Country:US
Mailing Address - Phone:417-569-8706
Mailing Address - Fax:
Practice Address - Street 1:2610 BERMUDA LAKE DR
Practice Address - Street 2:APT. 202
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33510
Practice Address - Country:US
Practice Address - Phone:417-569-8706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist