1780815282 NPI number — ELIZABETH GAY BARKER MFT

Table of content: ELIZABETH GAY BARKER MFT (NPI 1780815282)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780815282 NPI number — ELIZABETH GAY BARKER MFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARKER
Provider First Name:
ELIZABETH
Provider Middle Name:
GAY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RATLIFF
Provider Other First Name:
ELIZABETH
Provider Other Middle Name:
GAY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1780815282
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/31/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
506 HOLCOMB AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RENO
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89502-1802
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
775-741-5800
Provider Business Mailing Address Fax Number:
775-786-5062

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
506 HOLCOMB AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RENO
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89502-1802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-741-5800
Provider Business Practice Location Address Fax Number:
775-786-5062
Provider Enumeration Date:
07/31/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  NV #0353 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)