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General NPI Number Information
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NPI Number | 1215336300
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Entity Type | Individual
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Provider Name | ASTRA BARKLEY MS
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Gender | Female
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Dates
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Enumeration Date | 08/14/2014
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Last Update Date | 08/14/2014
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Provider Practice Location Address
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Address Line | 557 GLOVER AVE SUITE 3
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City | ENTERPRISE
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State | AL
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Zip | 36330-2024
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Country | US
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Telephone | 334-347-1862
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 310954
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City | ENTERPRISE
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State | AL
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Zip | 36331-0954
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Country | US
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Telephone | 334-806-6182
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | C2118A
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License Number State | AL
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