Provider Demographics
NPI:1366636433
Name:ANDERSON, BARBARA JEAN (MS, CCC/SP)
Entity Type:Individual
Prefix:MS
First Name:BARBARA JEAN
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MS, CCC/SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6817 GEORGIA AVENUE, N.W.
Mailing Address - Street 2:APT. 516
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012
Mailing Address - Country:US
Mailing Address - Phone:301-908-5418
Mailing Address - Fax:
Practice Address - Street 1:1300 NICHOLSON STREET, N.W.
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011
Practice Address - Country:US
Practice Address - Phone:202-722-5670
Practice Address - Fax:202-576-6168
Is Sole Proprietor?:No
Enumeration Date:2007-08-31
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4329235Z00000X
DCSLP000471235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist