Provider Demographics
NPI:1063962546
Name:BARKER, BEVON ORLANDO (BA)
Entity type:Individual
Prefix:MR
First Name:BEVON
Middle Name:ORLANDO
Last Name:BARKER
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1906 BROMLEY EST
Mailing Address - Street 2:
Mailing Address - City:PINE HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-6429
Mailing Address - Country:US
Mailing Address - Phone:609-206-8080
Mailing Address - Fax:
Practice Address - Street 1:1906 BROMLEY EST
Practice Address - Street 2:
Practice Address - City:PINE HILL
Practice Address - State:NJ
Practice Address - Zip Code:08021-6429
Practice Address - Country:US
Practice Address - Phone:609-206-8080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health