Most Relevant Information
Provider Data
| NPI Number: | 1003649179 |
| Provider Name: | IDIATOU BARRY |
| Entity Type: | Individual |
| Taxonomy Code: | 251S00000X |
| Specialty: | Community/Behavioral Health |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/23/2024 |
| Last Updated: | 08/23/2024 |
Provider Practice Location
2323 LAKE CLUB DR STE 204
COLUMBUS
OH
432323198
Practice Location Phone/Fax
| Phone: | 6148242835 |
| Fax: |
Provider Mailing Location
2323 LAKE CLUB DR STE 204
COLUMBUS
OH
432323198
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |