Provider Demographics
NPI:1013769447
Name:BARRIE, AMANDA
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:BARRIE
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 1:5061 COUNTY ROAD 353
Mailing Address - Street 2:
Mailing Address - City:BRAZORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77422-7239
Mailing Address - Country:US
Mailing Address - Phone:361-676-8759
Mailing Address - Fax:
Practice Address - Street 1:5061 COUNTY ROAD 353
Practice Address - Street 2:
Practice Address - City:BRAZORIA
Practice Address - State:TX
Practice Address - Zip Code:77422-7239
Practice Address - Country:US
Practice Address - Phone:361-676-8759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician