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NPI Code Detail

MEDICARE: ASHLEE SHERAINE BARNES

MEDICARE: ASHLEE SHERAINE BARNES
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1255158937
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEE SHERAINE BARNES
Provider Business Mailing Address
First Line : 3007 HARBOR LN N STE 1200
Second Line :
City : PLYMOUTH
State : MN
Zip : 55447-5138
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3007 HARBOR LN N
Second Line :
City : PLYMOUTH
State : MN
Zip : 55447-5112
Country : US
Telephone Number : 612-439-4650
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2024
Last Update Date : 09/24/2024

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Directions to “ ASHLEE SHERAINE BARNES ” Practice Location

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