Provider Demographics
NPI:1134276728
Name:BARBER, PATRICIA PARRY (MS)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:PARRY
Last Name:BARBER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 W STATE ROAD 434
Mailing Address - Street 2:SUITE 215
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-4980
Mailing Address - Country:US
Mailing Address - Phone:407-767-8854
Mailing Address - Fax:
Practice Address - Street 1:225 W STATE ROAD 434
Practice Address - Street 2:SUITE 215
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4980
Practice Address - Country:US
Practice Address - Phone:407-767-8854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH573101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH573OtherLICENSURE NUMBER