Provider Demographics
NPI:1023369758
Name:OLDHAM, BARBARA JEAN (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:JEAN
Last Name:OLDHAM
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 DALLAS ST
Mailing Address - Street 2:CHETEK
Mailing Address - City:CHETEK
Mailing Address - State:WI
Mailing Address - Zip Code:54728-9118
Mailing Address - Country:US
Mailing Address - Phone:262-812-7139
Mailing Address - Fax:
Practice Address - Street 1:725 W PARK AVE
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-3276
Practice Address - Country:US
Practice Address - Phone:715-720-2071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-20
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2822-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist