Individual
MRS. ELAINE LESLIE BARNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA IECE
Contact information
Practice address
516 OLIVER DR, SOUTH FULTON, TN 38257-2450
(731) 335-5450
Mailing address
516 OLIVER DR, SOUTH FULTON, TN 38257-2450
(731) 335-3397
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
200204994
KY
Other
Enumeration date
06/11/2013
Last updated
06/11/2013
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