Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 34004399A | IN |
NPI | 1003863085 |
---|---|
Provider Name | Peggy B Barnes |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202-2207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2006 |
Last Update Date | 24/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100389290 | (05) | IN |
P45803 | (02) | IN |