Provider Demographics
NPI:1962166298
Name:BARROW, MAHALIA
Entity type:Individual
Prefix:
First Name:MAHALIA
Middle Name:
Last Name:BARROW
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:MAHALIA
Other - Middle Name:
Other - Last Name:SIDIBE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3681 N DECATUR RD APT S12
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30032-1023
Mailing Address - Country:US
Mailing Address - Phone:209-224-6476
Mailing Address - Fax:
Practice Address - Street 1:3681 N DECATUR RD APT S12
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30032-1023
Practice Address - Country:US
Practice Address - Phone:209-224-6476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula