Individual
DARRELL EUGENE BARNACK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
3500 TOWER AVE, SUPERIOR, WI 54880-5335
(715) 395-5454
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1001-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013664
PREFERRED ONE
—
01
—
52Q13BA
BCBS OF MN
MN
Enumeration date
05/24/2006
Last updated
07/08/2007
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