Provider Demographics
NPI:1316494412
Name:JOLENE BARNETT
Entity type:Organization
Organization Name:JOLENE BARNETT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TEACHER
Authorized Official - Prefix:
Authorized Official - First Name:JOLENE
Authorized Official - Middle Name:ALICIA
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:347-981-3669
Mailing Address - Street 1:3464 WILSON AVE
Mailing Address - Street 2:APT 4B
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-2326
Mailing Address - Country:US
Mailing Address - Phone:347-981-3669
Mailing Address - Fax:
Practice Address - Street 1:3464 WILSON AVE
Practice Address - Street 2:APT 4B
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-2326
Practice Address - Country:US
Practice Address - Phone:347-981-3669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency