MEDICARE: JAYNAYA BARLOW

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1598374019
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAYNAYA BARLOW

Provider Business Mailing Address
First Line	:	13163 RANCH RD APT 2108
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-9462
Country	:	US
Telephone Number	:	313-444-3480
Fax Number	:	517-483-2461

Provider Business Practice Location Address
First Line	:	4211 OKEMOS RD STE 18
Second Line	:
City	:	OKEMOS
State	:	MI
Zip	:	48864-3287
Country	:	US
Telephone Number	:	313-444-3480
Fax Number	:	517-483-2461

Authorized Official
Title or Position	:	CREDENTIALING MANGER
Name	:	CATHY GALLEGOS
Credential	:
Telephone Number	:	517-483-2461

Provider Enumeration Date	:	07/30/2020
Last Update Date	:	12/02/2024

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