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General NPI Number Information
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NPI Number | 1699956193
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Entity Type | Organization
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Legal Business Name | JO ANN BARNES PHD PC
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Dates
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Enumeration Date | 11/26/2007
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Last Update Date | 11/26/2007
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Provider Practice Location Address
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Address Line | 355 HIGH ST SE
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City | SALEM
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State | OR
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Zip | 97301-3613
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Country | US
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Telephone | 503-763-2922
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Fax | 503-763-2641
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Provider Business Mailing Address
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Address Line | 355 HIGH ST SE
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City | SALEM
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State | OR
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Zip | 97301-3613
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Country | US
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Telephone | 503-763-2922
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Fax | 503-763-2641
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. JO ANN BARNES
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Credential | PH D
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Telephone | 503-763-2922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0901
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License Number State | OR
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