Provider Demographics
NPI:1922516533
Name:GREENWOOD, BARBARA JOANNE
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:JOANNE
Last Name:GREENWOOD
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 1:206 MAPLE AVE E
Mailing Address - Street 2:
Mailing Address - City:MORA
Mailing Address - State:MN
Mailing Address - Zip Code:55051-1311
Mailing Address - Country:US
Mailing Address - Phone:320-679-3580
Mailing Address - Fax:320-679-3579
Practice Address - Street 1:206 MAPLE AVE E
Practice Address - Street 2:
Practice Address - City:MORA
Practice Address - State:MN
Practice Address - Zip Code:55051-1311
Practice Address - Country:US
Practice Address - Phone:320-679-3580
Practice Address - Fax:320-679-3579
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-17
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)