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General NPI Number Information
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NPI Number | 1376770438
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Entity Type | Individual
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Provider Name | FRED P BARKER LPC
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Gender | Male
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Dates
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Enumeration Date | 06/16/2009
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Last Update Date | 11/11/2022
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Provider Practice Location Address
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Address Line | 24 W MAIN ST STE 311
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City | WENTZVILLE
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State | MO
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Zip | 63385-1600
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Country | US
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Telephone | 636-486-6359
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Fax |
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Provider Business Mailing Address
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Address Line | 31 COYOTE RIDGE LN
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City | DEFIANCE
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State | MO
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Zip | 63341-1360
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Country | US
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Telephone | 636-485-0470
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2005041410
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License Number State | MO
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