Provider Demographics
NPI:1982798070
Name:KELBAN, BARBARA RONA (MSW)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:RONA
Last Name:KELBAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6559 VIA REGINA
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3912
Mailing Address - Country:US
Mailing Address - Phone:561-665-1174
Mailing Address - Fax:561-955-1966
Practice Address - Street 1:6559 VIA REGINA
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3912
Practice Address - Country:US
Practice Address - Phone:561-665-1174
Practice Address - Fax:561-955-1966
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW69621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU1476ZMedicare ID - Type UnspecifiedMEDICARE NUMBER