Provider Demographics
NPI:1417177213
Name:BARNES, KATHRYN ANN
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANN
Last Name:BARNES
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 1:6727 CARMEL DR
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-8770
Mailing Address - Country:US
Mailing Address - Phone:610-965-8777
Mailing Address - Fax:610-965-7078
Practice Address - Street 1:5182 LAURIE DR
Practice Address - Street 2:
Practice Address - City:EMMAUS
Practice Address - State:PA
Practice Address - Zip Code:18049-5054
Practice Address - Country:US
Practice Address - Phone:610-965-2458
Practice Address - Fax:610-965-7078
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL007361235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101351406001OtherMEDICAL ASSISTANCE