Healthcare Provider Details

I. General information

NPI: 1427583160
Provider Name (Legal Business Name): ,L.KIMBERLY BARKER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2017
Last Update Date: 05/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RR 2 BOX 433
DELBARTON WV
25670-9775
US

IV. Provider business mailing address

RR 2 BOX 433
DELBARTON WV
25670-9775
US

V. Phone/Fax

Practice location:
  • Phone: 304-475-5249
  • Fax:
Mailing address:
  • Phone: 304-475-5249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number2211-9195
License Number StateWV

VIII. Authorized Official

Name: KIMBERLY ELIZABETH BARKER
Title or Position: OWNER
Credential: M.A., L.S.W.
Phone: 304-475-5249