Provider Demographics
NPI:1487143814
Name:BARLOW, STEPHANIE REGINA
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:REGINA
Last Name:BARLOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:REGINA
Other - Last Name:GAINES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:205 YORKSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-8350
Mailing Address - Country:US
Mailing Address - Phone:716-876-3902
Mailing Address - Fax:
Practice Address - Street 1:205 YORKSHIRE RD
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-8350
Practice Address - Country:US
Practice Address - Phone:716-876-3902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-01
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist