Healthcare Provider Details

I. General information

NPI: 1932142494
Provider Name (Legal Business Name): CANICE M BARNETT PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3884 WOODTHRUSH RD
AKRON OH
44333-1527
US

IV. Provider business mailing address

3884 WOODTHRUSH RD
AKRON OH
44333-1527
US

V. Phone/Fax

Practice location:
  • Phone: 330-329-2063
  • Fax: 330-665-3142
Mailing address:
  • Phone: 330-329-2063
  • Fax: 330-665-3142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4525
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: