Provider Demographics
NPI:1437202066
Name:BARNES-COOPER, MELETHIA JEUENEESE (MA, CCC)
Entity Type:Individual
Prefix:MRS
First Name:MELETHIA
Middle Name:JEUENEESE
Last Name:BARNES-COOPER
Suffix:
Gender:F
Credentials:MA, CCC
Other - Prefix:
Other - First Name:MELETHIA
Other - Middle Name:JEUENEESE
Other - Last Name:BARNES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, CCC
Mailing Address - Street 1:32622 WILLOWVAIL CIR
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-1854
Mailing Address - Country:US
Mailing Address - Phone:951-303-3368
Mailing Address - Fax:
Practice Address - Street 1:3020 CHILDRENS WAY
Practice Address - Street 2:MC 5010
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4223
Practice Address - Country:US
Practice Address - Phone:858-966-5838
Practice Address - Fax:858-278-6627
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8368235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist