Provider Demographics
NPI:1225132855
Name:PERRY, BARBARA ETT (MED, CMHT)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ETT
Last Name:PERRY
Suffix:
Gender:F
Credentials:MED, CMHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 ALLEN CORNER RD
Mailing Address - Street 2:
Mailing Address - City:LAMAR
Mailing Address - State:MS
Mailing Address - Zip Code:38642-8103
Mailing Address - Country:US
Mailing Address - Phone:662-252-6208
Mailing Address - Fax:
Practice Address - Street 1:214 INDUSTRIAL RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:MS
Practice Address - Zip Code:38603-6761
Practice Address - Country:US
Practice Address - Phone:662-224-0078
Practice Address - Fax:662-224-0079
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health