Healthcare Provider Details

I. General information

NPI: 1780041137
Provider Name (Legal Business Name): DR. ARETHA BARNES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2016
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3415 BELLINGHAM RD NONE
COLUMBIA SC
29203-5520
US

IV. Provider business mailing address

1000 WINDSOR SHORES DR APT 11B
COLUMBIA SC
29223-1713
US

V. Phone/Fax

Practice location:
  • Phone: 803-529-4072
  • Fax:
Mailing address:
  • Phone: 803-529-4072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: