Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | PT 007118 | GA |
NPI | 1124571013 |
---|---|
Provider Name | Dr. Cathleen Price Barrett |
First Address | Suwanee, GA 30024-6873 |
Second Address | Suwanee, GA 30024-6873 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2016 |
Last Update Date | 27/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000913558F | (05) | GA |