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General NPI Number Information
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NPI Number | 1518686823
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Entity Type | Individual
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Provider Name | CASSANDRA BARKLEY
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Gender | Female
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Dates
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Enumeration Date | 08/22/2022
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Last Update Date | 08/22/2022
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Provider Practice Location Address
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Address Line | 8046 WELLS RD W LOT 33
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City | THEODORE
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State | AL
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Zip | 36582
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Country | US
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Telephone | 251-307-6696
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Fax |
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Provider Business Mailing Address
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Address Line | 8046 WELLS RD W LOT 33
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City | THEODORE
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State | AL
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Zip | 36582-7849
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Country | US
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Telephone |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | AL
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