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General NPI Number Information
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NPI Number | 1265541429
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Entity Type | Individual
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Provider Name | BARBARA HOLLAND FLYNT-WAMPLER LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 600 EAST UNAKA AVE
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City | JOHNSON CITY
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State | TN
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Zip | 37601
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Country | US
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Telephone | 423-928-6993
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Fax | 276-669-2159
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Provider Business Mailing Address
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Address Line | 149 SPRING BRANCH RD
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City | BRISTOL
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State | VA
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Zip | 24201
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Country | US
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Telephone | 276-669-4333
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Fax | 276-669-2159
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1112
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904002344
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License Number State | VA
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