Provider Demographics
NPI:1194564898
Name:BARBRE, KARLY HELENE HOPE
Entity type:Individual
Prefix:
First Name:KARLY
Middle Name:HELENE HOPE
Last Name:BARBRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8601 W MCNAB RD APT 421
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-3244
Mailing Address - Country:US
Mailing Address - Phone:954-292-5826
Mailing Address - Fax:
Practice Address - Street 1:7100 W COMMERCIAL BLVD STE 106
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-2147
Practice Address - Country:US
Practice Address - Phone:954-292-5826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician