Healthcare Provider Details

I. General information

NPI: 1861203374
Provider Name (Legal Business Name): BRIAN JAMES BARRON BS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2025
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14930 LAPLAISANCE RD
MONROE MI
48161-3880
US

IV. Provider business mailing address

14930 LAPLAISANCE RD
MONROE MI
48161-3880
US

V. Phone/Fax

Practice location:
  • Phone: 734-344-5269
  • Fax: 734-430-8188
Mailing address:
  • Phone: 734-344-5269
  • Fax: 734-430-8188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: