Provider Demographics
NPI:1437390994
Name:WELLS, BARBARA JILL (MA)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:JILL
Last Name:WELLS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22151 MOROSS RD
Mailing Address - Street 2:PROF BLDG. I, SUITE 223
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48236-2167
Mailing Address - Country:US
Mailing Address - Phone:313-343-4436
Mailing Address - Fax:313-343-4111
Practice Address - Street 1:22151 MOROSS RD
Practice Address - Street 2:PROF BLDG. I, SUITE 223
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48236-2167
Practice Address - Country:US
Practice Address - Phone:313-343-4436
Practice Address - Fax:313-343-4111
Is Sole Proprietor?:No
Enumeration Date:2009-03-13
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000318231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist