Individual
TIMILLA BARKSDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 BROADWAY, GARY, IN 46407-2239
(219) 628-3721
(219) 882-0210
Mailing address
1601 BROADWAY, GARY, IN 46407-2239
(219) 628-3721
(219) 882-0210
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
04/19/2013
Last updated
04/19/2013
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