MEDICARE: DR. BARBARA JEAN PALOMBI 103T00000X

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	103T00000X	Psychologist	6301009839	MI

General Provider Information

NPI Number	:	1205176567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARBARA JEAN PALOMBI 103T00000X

Provider Business Mailing Address
First Line	:	2442 CRANE AVE
Second Line	:
City	:	FORT SILL
State	:	OK
Zip	:	73503-4429
Country	:	US
Telephone Number	:	580-442-4832
Fax Number	:	580-442-7604

Provider Business Practice Location Address
First Line	:	2442 CRANE AVE
Second Line	:
City	:	FORT SILL
State	:	OK
Zip	:	73503-4429
Country	:	US
Telephone Number	:	580-442-4832
Fax Number	:	580-442-7604

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

Provider Enumeration Date	:	02/25/2013
Last Update Date	:	02/25/2013

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