Basic Information
| Provider Information | |||||||||
| NPI: | 1811253271 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARRY | ||||||||
| FirstName: | JAY | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8501 E ALAMEDA AVE | ||||||||
| Address2: | APT 831 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802306891 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6626461027 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4500 CHERRY CREEK DR. SOUTH | ||||||||
| Address2: | SUITE 940 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80246 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033227108 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2012 | ||||||||
| LastUpdateDate: | 04/10/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.