Provider Demographics
NPI:1467936054
Name:BARAN, MARY K (MS SLP-CCC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:K
Last Name:BARAN
Suffix:
Gender:F
Credentials:MS SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4616 CHERYL DR
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-8705
Mailing Address - Country:US
Mailing Address - Phone:610-417-6101
Mailing Address - Fax:
Practice Address - Street 1:430 NAZARETH PIKE
Practice Address - Street 2:
Practice Address - City:NAZARETH
Practice Address - State:PA
Practice Address - Zip Code:18064-9615
Practice Address - Country:US
Practice Address - Phone:610-365-2437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL012641235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist