Provider Demographics
NPI:1265079552
Name:BARNOSKY, VICTORIA JO
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:JO
Last Name:BARNOSKY
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:PO BOX 2225
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74821-2225
Mailing Address - Country:US
Mailing Address - Phone:580-210-3129
Mailing Address - Fax:
Practice Address - Street 1:1301 N OAK AVE APT 207
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-1218
Practice Address - Country:US
Practice Address - Phone:580-210-3129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health