Provider Demographics
NPI:1811522345
Name:BARRETT, RASHIDAH
Entity type:Individual
Prefix:
First Name:RASHIDAH
Middle Name:
Last Name:BARRETT
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 1:223 GREENFIELD CRES
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-4882
Mailing Address - Country:US
Mailing Address - Phone:757-567-3015
Mailing Address - Fax:
Practice Address - Street 1:223 GREENFIELD CRES
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-4882
Practice Address - Country:US
Practice Address - Phone:757-567-3015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA385H00000XMedicaid