Doctor Name: | MS. AMY JO BARRON |
NPI Number: | 1700187929 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ICCAADC, MSSW |
License Number: | C0098 |
Business Practice Address: | 1875 Fant Dr Fort Oglethorpe, GA - 307423307 |
Business Phone Number: | 7068061120 |
Business Fax Number: | |
Mailing Address: | 1875 Fant Dr, FORT OGLETHORPE |
State: | GA |
Postal Code: | 307423307 |
Phone Number: | 7068061120 |
Fax Number: | |
NPI Enumeration Date: | 11/04/2010 |
NPI Last Update Date: | 11/04/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | C0098 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |