Provider Demographics
NPI:1669228953
Name:BARNER, KEYOKO (MFT)
Entity type:Individual
Prefix:
First Name:KEYOKO
Middle Name:
Last Name:BARNER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 N HUALAPAI WAY UNIT 2113
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-8089
Mailing Address - Country:US
Mailing Address - Phone:818-564-8899
Mailing Address - Fax:
Practice Address - Street 1:3450 N HUALAPAI WAY UNIT 2113
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-8089
Practice Address - Country:US
Practice Address - Phone:818-564-8899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI4363101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health