Provider Demographics
NPI:1477724342
Name:BARNO, JEANNE ELLEN (MA-CCC-A)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:ELLEN
Last Name:BARNO
Suffix:
Gender:F
Credentials:MA-CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4380 GEORGETOWN SQ
Mailing Address - Street 2:STE 1002
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6254
Mailing Address - Country:US
Mailing Address - Phone:770-220-8408
Mailing Address - Fax:770-234-9979
Practice Address - Street 1:2406 LIGHTHOUSE MANOR DRIVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-7401
Practice Address - Country:US
Practice Address - Phone:770-536-4352
Practice Address - Fax:770-532-8165
Is Sole Proprietor?:No
Enumeration Date:2008-03-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003746231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA511I640043Medicare PIN