Healthcare Provider Details

I. General information

NPI: 1720363989
Provider Name (Legal Business Name): INGRID GABRIELA BARRERA PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2011
Last Update Date: 10/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 NW 14TH ST ROOM 1467
MIAMI FL
33136-2107
US

IV. Provider business mailing address

1120 NW 14TH ST ROOM 1467
MIAMI FL
33136-2107
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-4129
  • Fax: 305-243-5233
Mailing address:
  • Phone: 305-243-4129
  • Fax: 305-243-5233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberPY8423
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: