MEDICARE: TIANA BARROS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1104256148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIANA BARROS

Provider Business Mailing Address
First Line	:	4429 LAWRENCE ST
Second Line	:	2029
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-3251
Country	:	US
Telephone Number	:	774-269-5483
Fax Number	:

Provider Business Practice Location Address
First Line	:	4429 LAWRENCE ST
Second Line	:	2029
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-3251
Country	:	US
Telephone Number	:	774-269-5483
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2013
Last Update Date	:	11/12/2013

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Directions to “ TIANA BARROS ” Practice Location

Language	Start Address	Practice Location

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