Provider Demographics
NPI:1154395283
Name:CLOUES, BARBARA ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:ANN
Last Name:CLOUES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:BARBARA
Other - Middle Name:ANN
Other - Last Name:WALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1211 S R 436
Mailing Address - Street 2:SUITE 113 NEUROPSYCHOLOGY & BEHAVIORAL HEALTH CONSULTAN
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707
Mailing Address - Country:US
Mailing Address - Phone:407-740-0007
Mailing Address - Fax:407-740-8360
Practice Address - Street 1:1211 S R 436
Practice Address - Street 2:SUITE 113 NEUROPSYCHOLOGY & BEHAVIORAL HEALTH CONSULTAN
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707
Practice Address - Country:US
Practice Address - Phone:407-740-0007
Practice Address - Fax:407-740-8360
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6514103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL54850AMedicare ID - Type Unspecified