Provider Demographics
NPI:1275779381
Name:STADNICKI, BARBARA A (MA -CCC, SPEECH-LANG)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:A
Last Name:STADNICKI
Suffix:
Gender:F
Credentials:MA -CCC, SPEECH-LANG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BEACON HILL DR
Mailing Address - Street 2:
Mailing Address - City:MORRISONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12962-9666
Mailing Address - Country:US
Mailing Address - Phone:518-643-0101
Mailing Address - Fax:
Practice Address - Street 1:10 BEACON HILL DR
Practice Address - Street 2:
Practice Address - City:MORRISONVILLE
Practice Address - State:NY
Practice Address - Zip Code:12962-9666
Practice Address - Country:US
Practice Address - Phone:518-643-0101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-18
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003065-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY003065-1OtherSTATE LICENSE