Provider Demographics
NPI:1093148157
Name:LOUGHRAN, BARBARA BURLINGAME
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:BURLINGAME
Last Name:LOUGHRAN
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 1:212 PARK ST
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-3544
Mailing Address - Country:US
Mailing Address - Phone:407-461-1204
Mailing Address - Fax:
Practice Address - Street 1:212 PARK ST
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-3544
Practice Address - Country:US
Practice Address - Phone:407-461-1204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9511005101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor