Provider Demographics
NPI:1073835823
Name:SLOCUM, BARBARA ANNE MARIE (MED CCC SLP)
Entity Type:Individual
Prefix:MS
First Name:BARBARA ANNE
Middle Name:MARIE
Last Name:SLOCUM
Suffix:
Gender:F
Credentials:MED CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1254 NY RT 369
Mailing Address - Street 2:
Mailing Address - City:CHENANGO FORKS
Mailing Address - State:NY
Mailing Address - Zip Code:13746-1716
Mailing Address - Country:US
Mailing Address - Phone:607-648-5644
Mailing Address - Fax:
Practice Address - Street 1:225 FRONT ST.
Practice Address - Street 2:BROOME COUNTY HEALTH DPT.
Practice Address - City:BINGHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:13905-2474
Practice Address - Country:US
Practice Address - Phone:607-778-3930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015188-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist