Healthcare Provider Details

I. General information

NPI: 1073802005
Provider Name (Legal Business Name): JOANN BARILE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2011
Last Update Date: 03/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

862 S MAIN ST
BRIGHAM CITY UT
84302-3320
US

IV. Provider business mailing address

862 S MAIN ST
BRIGHAM CITY UT
84302-3320
US

V. Phone/Fax

Practice location:
  • Phone: 235-723-1799
  • Fax: 801-731-0841
Mailing address:
  • Phone: 235-723-1799
  • Fax: 801-731-0841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: