Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003241993 |
---|---|
Provider Name | Cheryl Barnes |
First Address | Michigan City, IN 46360-7354 |
Second Address | Michigan City, IN 46360-7354 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2013 |
Last Update Date | 10/09/2013 |