Provider Demographics
NPI:1295043214
Name:BODENHAMER, BARBARA A
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:A
Last Name:BODENHAMER
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 1:8908 OLD SANTA FE RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64138-3911
Mailing Address - Country:US
Mailing Address - Phone:816-316-7950
Mailing Address - Fax:
Practice Address - Street 1:8908 OLD SANTA FE RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64138-3911
Practice Address - Country:US
Practice Address - Phone:816-316-7950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist