Provider Demographics
NPI:1912270828
Name:BARNES, DESIRAY LYNN (BA)
Entity Type:Individual
Prefix:
First Name:DESIRAY
Middle Name:LYNN
Last Name:BARNES
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 CARMEL CT
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-5208
Mailing Address - Country:US
Mailing Address - Phone:970-846-5023
Mailing Address - Fax:
Practice Address - Street 1:1409 CARMEL CT
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-5208
Practice Address - Country:US
Practice Address - Phone:970-846-5023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-23
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management