Provider Demographics
NPI:1831334317
Name:CONRAD, BARBARA ANNE (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:ANNE
Last Name:CONRAD
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:MISS
Other - First Name:BARBARA
Other - Middle Name:ANNE
Other - Last Name:CONRAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MASSAGE THERAPIST
Mailing Address - Street 1:4253 HIGH MESA RD SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-1428
Mailing Address - Country:US
Mailing Address - Phone:505-414-0938
Mailing Address - Fax:
Practice Address - Street 1:392 BENCHOR ST
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-4202
Practice Address - Country:US
Practice Address - Phone:516-987-8043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-11
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM5940225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist