Provider Demographics
NPI:1306470828
Name:BARNY, BLYTHE RACHEL (MSOM, LAC)
Entity type:Individual
Prefix:
First Name:BLYTHE
Middle Name:RACHEL
Last Name:BARNY
Suffix:
Gender:F
Credentials:MSOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 BALTIMORE ST STE 111
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-3091
Mailing Address - Country:US
Mailing Address - Phone:303-564-5183
Mailing Address - Fax:
Practice Address - Street 1:69 WOLF ACRES DR LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-2048
Practice Address - Country:US
Practice Address - Phone:301-533-2190
Practice Address - Fax:301-533-2198
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-24
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02669171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist