Provider Demographics
NPI:1326553504
Name:DOUGLAS, BARBARA M (SLP)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:M
Last Name:DOUGLAS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9911 COURTHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22553-1703
Mailing Address - Country:US
Mailing Address - Phone:540-891-0400
Mailing Address - Fax:540-891-0405
Practice Address - Street 1:9911 COURTHOUSE RD
Practice Address - Street 2:
Practice Address - City:SPOTSYLVANIA
Practice Address - State:VA
Practice Address - Zip Code:22553-1703
Practice Address - Country:US
Practice Address - Phone:540-891-0400
Practice Address - Fax:540-891-0405
Is Sole Proprietor?:No
Enumeration Date:2017-12-09
Last Update Date:2017-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202007841235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist