Provider Demographics
NPI:1093990087
Name:STOBAUGH, BARBARA ANNE (DT)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:ANNE
Last Name:STOBAUGH
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1927 N GRACELAND AVE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-4039
Mailing Address - Country:US
Mailing Address - Phone:217-972-6468
Mailing Address - Fax:217-875-3608
Practice Address - Street 1:1927 N GRACELAND AVE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-4039
Practice Address - Country:US
Practice Address - Phone:217-972-6468
Practice Address - Fax:217-875-3608
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist