Provider Demographics
NPI:1952458440
Name:BARRON, MARY JOLEEN (PHD, ATC)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:JOLEEN
Last Name:BARRON
Suffix:
Gender:F
Credentials:PHD, ATC
Other - Prefix:
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Mailing Address - Street 1:15016 KAMPUTA DR
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-1449
Mailing Address - Country:US
Mailing Address - Phone:703-537-6845
Mailing Address - Fax:202-994-3601
Practice Address - Street 1:950 NEW HAMPSHIRE AVE NW STE 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2301
Practice Address - Country:US
Practice Address - Phone:202-994-4818
Practice Address - Fax:202-994-3601
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01260014962255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer