Provider Demographics
NPI:1750716650
Name:BARRIOS, KYRA SUE
Entity type:Individual
Prefix:
First Name:KYRA
Middle Name:SUE
Last Name:BARRIOS
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 1:625 INDIAN ROW CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89011-1818
Mailing Address - Country:US
Mailing Address - Phone:702-643-7319
Mailing Address - Fax:
Practice Address - Street 1:625 INDIAN ROW CT
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89011-1818
Practice Address - Country:US
Practice Address - Phone:702-643-7319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner