Provider Demographics
NPI:1386800217
Name:AYSTA, BARBARA J (PSYD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:AYSTA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3203 W 3RD AVE
Mailing Address - Street 2:RANGE MENTAL HEALTH CENTER-PERPICH BUILDING
Mailing Address - City:HIBBING
Mailing Address - State:MN
Mailing Address - Zip Code:55746
Mailing Address - Country:US
Mailing Address - Phone:218-263-9237
Mailing Address - Fax:218-262-3150
Practice Address - Street 1:3203 W 3RD AVE
Practice Address - Street 2:RANGE MENTAL HEALTH CENTER-PERPICH BUILDING
Practice Address - City:HIBBING
Practice Address - State:MN
Practice Address - Zip Code:55746
Practice Address - Country:US
Practice Address - Phone:218-263-9237
Practice Address - Fax:218-262-3150
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist