1386800217 NPI number — BARBARA J AYSTA PSYD

Table of content: BARBARA J AYSTA PSYD (NPI 1386800217)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386800217 NPI number — BARBARA J AYSTA PSYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AYSTA
Provider First Name:
BARBARA
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PSYD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386800217
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3203 W 3RD AVE
Provider Second Line Business Mailing Address:
RANGE MENTAL HEALTH CENTER-PERPICH BUILDING
Provider Business Mailing Address City Name:
HIBBING
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55746
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
218-263-9237
Provider Business Mailing Address Fax Number:
218-262-3150

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3203 W 3RD AVE
Provider Second Line Business Practice Location Address:
RANGE MENTAL HEALTH CENTER-PERPICH BUILDING
Provider Business Practice Location Address City Name:
HIBBING
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55746
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-263-9237
Provider Business Practice Location Address Fax Number:
218-262-3150
Provider Enumeration Date:
07/30/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)