Provider Demographics
NPI:1467190280
Name:BARNES, DAVID P (MS, CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:P
Last Name:BARNES
Suffix:
Gender:M
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 DUDLEY ST APT 2
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-1869
Mailing Address - Country:US
Mailing Address - Phone:617-335-9002
Mailing Address - Fax:
Practice Address - Street 1:14 DUDLEY ST APT 2
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-1869
Practice Address - Country:US
Practice Address - Phone:617-335-9002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA77481235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist