Healthcare Provider Details

I. General information

NPI: 1437729019
Provider Name (Legal Business Name): CASSANDRA M BARRETT PHD, MS GC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 06/28/2021
Certification Date: 06/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 LEE ST PRIMARY CARE RM G101B
CHARLOTTESVILLE VA
22908-0001
US

IV. Provider business mailing address

326 10 1/2 ST NW UNIT B
CHARLOTTESVILLE VA
22903-2320
US

V. Phone/Fax

Practice location:
  • Phone: 434-297-4298
  • Fax: 434-297-4238
Mailing address:
  • Phone: 434-297-4298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number0140000025
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: