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General NPI Number Information
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NPI Number | 1306042379
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Entity Type | Individual
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Provider Name | TRACEY BETH BARLOW SOCIAL WORKER
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Gender | Female
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 03/21/2018
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Provider Practice Location Address
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Address Line | 25 E VARGO RD
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City | HORSEHEADS
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State | NY
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Zip | 14845-9319
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Country | US
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Telephone | 607-592-8569
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Fax |
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Provider Business Mailing Address
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Address Line | 25 E VARGO RD
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City | HORSEHEADS
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State | NY
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Zip | 14845-9319
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Country | US
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Telephone | 607-592-8569
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 614075
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 213027-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 094647
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License Number State | NY
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