| Doctor Name: | MARY BARNES |
| NPI Number: | 1104206747 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | C.A.T.C |
| License Number: | B0412010939 |
| Business Practice Address: | 4187 Windsong Dr Tracy, CA - 953778738 |
| Business Phone Number: | 5103018794 |
| Business Fax Number: | |
| Mailing Address: | 4187 Windsong Dr, TRACY |
| State: | CA |
| Postal Code: | 953778738 |
| Phone Number: | 5103018794 |
| Fax Number: | |
| NPI Enumeration Date: | 06/08/2015 |
| NPI Last Update Date: | 06/08/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | B0412010939 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |