Individual
STACIE BARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3030 GRANADA AVE N, SUITE B, OAKDALE, MN 55128-3543
(651) 209-1111
(651) 779-7896
Mailing address
3030 GRANADA AVE N, SUITE B, OAKDALE, MN 55128-3543
(651) 209-1111
(651) 779-7896
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
10847801HCBS
MN
Other
Enumeration date
02/07/2017
Last updated
02/07/2017
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