Provider Demographics
NPI:1134358914
Name:TWITE-BARRY, KAREN JEAN (NCTMB)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:JEAN
Last Name:TWITE-BARRY
Suffix:
Gender:F
Credentials:NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8231 JOHNSON AVE S
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55437-1211
Mailing Address - Country:US
Mailing Address - Phone:952-921-9784
Mailing Address - Fax:952-921-9784
Practice Address - Street 1:6642 PENN AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55423-2026
Practice Address - Country:US
Practice Address - Phone:612-861-2752
Practice Address - Fax:612-861-2752
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
148081-00225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist