Provider Demographics
NPI:1205176567
Name:PALOMBI, BARBARA JEAN (103T00000X)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:JEAN
Last Name:PALOMBI
Suffix:
Gender:F
Credentials:103T00000X
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:DODD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:103T00000X
Mailing Address - Street 1:2442 CRANE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT SILL
Mailing Address - State:OK
Mailing Address - Zip Code:73503-4429
Mailing Address - Country:US
Mailing Address - Phone:580-442-4832
Mailing Address - Fax:580-442-7604
Practice Address - Street 1:2442 CRANE AVE
Practice Address - Street 2:
Practice Address - City:FORT SILL
Practice Address - State:OK
Practice Address - Zip Code:73503-4429
Practice Address - Country:US
Practice Address - Phone:580-442-4832
Practice Address - Fax:580-442-7604
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-25
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301009839103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist