Provider Demographics
NPI:1407007842
Name:KNOWLEN, BARBARA SHAWN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:SHAWN
Last Name:KNOWLEN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 SPRINGWOOD CIR APT A
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-5051
Mailing Address - Country:US
Mailing Address - Phone:407-234-5473
Mailing Address - Fax:
Practice Address - Street 1:164 SPRINGWOOD CIR APT A
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-5051
Practice Address - Country:US
Practice Address - Phone:407-234-5473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA3751235500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist