Provider Demographics
NPI:1366219800
Name:BARKER, OLIVIA A
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:A
Last Name:BARKER
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 1:17545 DOXTATER ST
Mailing Address - Street 2:
Mailing Address - City:ADAMS
Mailing Address - State:NY
Mailing Address - Zip Code:13605-2122
Mailing Address - Country:US
Mailing Address - Phone:315-771-5789
Mailing Address - Fax:
Practice Address - Street 1:17545 DOXTATER ST
Practice Address - Street 2:
Practice Address - City:ADAMS
Practice Address - State:NY
Practice Address - Zip Code:13605-2122
Practice Address - Country:US
Practice Address - Phone:315-771-5789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist