Provider Demographics
NPI:1003265794
Name:BARNO, MARY ANNE
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ANNE
Last Name:BARNO
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 1:4202 E CACTUS RD
Mailing Address - Street 2:APT 3204
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-7660
Mailing Address - Country:US
Mailing Address - Phone:619-971-7067
Mailing Address - Fax:
Practice Address - Street 1:4202 E CACTUS RD
Practice Address - Street 2:APT 3204
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-7660
Practice Address - Country:US
Practice Address - Phone:619-971-7067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA100262355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant