Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 18 006357 | NY |
Y | 101YM0800X | Mental Health Counselor | 18 006357 | NY |
N | 101YP1600X | Pastoral Counselor | 18 006357 | NY |
NPI | 1063810075 |
---|---|
Provider Name | Jerica Jalane Barber |
First Address | Williamsville, NY 14221-5781 |
Second Address | Williamsville, NY 14221-5781 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2014 |
Last Update Date | 22/09/2015 |