Provider Demographics
NPI:1124826763
Name:BARR, CARLA DAWN
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:DAWN
Last Name:BARR
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 442
Mailing Address - Street 2:
Mailing Address - City:CANVAS
Mailing Address - State:WV
Mailing Address - Zip Code:26662-0442
Mailing Address - Country:US
Mailing Address - Phone:304-619-1598
Mailing Address - Fax:
Practice Address - Street 1:131 WELLNESS DR
Practice Address - Street 2:
Practice Address - City:SUMMERSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26651-5402
Practice Address - Country:US
Practice Address - Phone:304-872-2659
Practice Address - Fax:304-872-1685
Is Sole Proprietor?:No
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach