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General NPI Number Information
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NPI Number | 1124981667
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Entity Type | Individual
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Provider Name | SYRIC BARBER LPCC
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Gender | Female
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 102 MARTY DR STE 2
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City | BUFFALO
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State | MN
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Zip | 55313-9345
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Country | US
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Telephone | 763-682-5420
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Fax |
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Provider Business Mailing Address
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Address Line | 10540 64TH LN NE
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City | ALBERTVILLE
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State | MN
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Zip | 55301-3531
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Country | US
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Telephone | 612-990-5053
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | L763651
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5330
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License Number State | MN
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