Doctor Name: | MARY ELLEN BARNES |
NPI Number: | 1447569546 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RAS |
License Number: | B0610311618 |
Business Practice Address: | 4020 Palos Verdes Dr N Suite 201 Rolling Hills Estates, CA - 902742525 |
Business Phone Number: | 3105416350 |
Business Fax Number: | |
Mailing Address: | 4020 Palos Verdes Dr N, Suite 201 ROLLING HILLS ESTATES |
State: | CA |
Postal Code: | 902742525 |
Phone Number: | 3105416350 |
Fax Number: | |
NPI Enumeration Date: | 10/07/2010 |
NPI Last Update Date: | 10/07/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | B0610311618 |
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: |