Provider Demographics
NPI:1336859503
Name:BARNWELL, DEVARIS E
Entity Type:Individual
Prefix:
First Name:DEVARIS
Middle Name:E
Last Name:BARNWELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5881 NW 57TH CT APT L203
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33319-2343
Mailing Address - Country:US
Mailing Address - Phone:954-669-6499
Mailing Address - Fax:
Practice Address - Street 1:5881 NW 57TH CT APT L203
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33319-2343
Practice Address - Country:US
Practice Address - Phone:954-669-6499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician