Provider Demographics
NPI:1114142395
Name:UTZ, BARBARA
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:UTZ
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 1:802 N GLENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62401-3200
Mailing Address - Country:US
Mailing Address - Phone:217-343-3089
Mailing Address - Fax:217-690-4846
Practice Address - Street 1:802 N GLENWOOD ST
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-3200
Practice Address - Country:US
Practice Address - Phone:217-343-3089
Practice Address - Fax:217-690-4846
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-14
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist