Provider Demographics
NPI:1427480961
Name:BARLOW, JEAN R
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:R
Last Name:BARLOW
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 1:1028 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-1315
Mailing Address - Country:US
Mailing Address - Phone:502-647-2477
Mailing Address - Fax:502-371-0890
Practice Address - Street 1:1028 MAIN ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-1315
Practice Address - Country:US
Practice Address - Phone:502-647-2477
Practice Address - Fax:502-371-0890
Is Sole Proprietor?:No
Enumeration Date:2013-08-07
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY246850101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY246850OtherSTATE LICENSE