Provider Demographics
NPI:1477746931
Name:GABRIEL-CONLEY, BARBARA J (MS/CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:GABRIEL-CONLEY
Suffix:
Gender:F
Credentials:MS/CCC-SLP
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:J
Other - Last Name:GABRIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16802 S COLEMAN ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85045-1209
Mailing Address - Country:US
Mailing Address - Phone:602-228-0640
Mailing Address - Fax:
Practice Address - Street 1:21256 E SUNSET DR
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-5074
Practice Address - Country:US
Practice Address - Phone:602-228-0640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-19
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1100235Z00000X
AZSLP1100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ438756Medicaid