Provider Demographics
NPI:1982846143
Name:BARNES, AMANDA B (MED/MA)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:B
Last Name:BARNES
Suffix:
Gender:F
Credentials:MED/MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 TAMARACK DR
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-2212
Mailing Address - Country:US
Mailing Address - Phone:401-524-8984
Mailing Address - Fax:
Practice Address - Street 1:8 TAMARACK DR
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-2212
Practice Address - Country:US
Practice Address - Phone:401-524-8984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00402101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health