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General NPI Number Information
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NPI Number | 1407910193
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Entity Type | Individual
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Provider Name | KENNETH C. BARKER THERAPIST
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Gender | Male
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1580 SAWGRASS COPERATE PARKWAY SUITE130
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City | SUNRISE
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State | FL
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Zip | 33323-2860
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Country | US
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Telephone | 954-315-4714
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Fax | 954-636-3054
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Provider Business Mailing Address
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Address Line | 1580 SAWGRASS COPERATE PARKWAY SUITE130
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City | SUNRISE
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State | FL
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Zip | 33323-2860
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Country | US
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Telephone | 954-315-4714
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Fax | 954-636-3054
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH7435
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License Number State | FL
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