Provider Demographics
NPI:1497552210
Name:BARRY, FATOUMATA
Entity type:Individual
Prefix:
First Name:FATOUMATA
Middle Name:
Last Name:BARRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8360 CASCADE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43240-2065
Mailing Address - Country:US
Mailing Address - Phone:614-599-8233
Mailing Address - Fax:614-599-8233
Practice Address - Street 1:4664 LARWELL DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-3621
Practice Address - Country:US
Practice Address - Phone:614-487-7805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician