Provider Demographics
NPI:1497110092
Name:BARBA, CATHERINE (MS, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:BARBA
Suffix:
Gender:F
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 1:1421 3RD ST SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-5204
Mailing Address - Country:US
Mailing Address - Phone:540-982-2208
Mailing Address - Fax:540-982-7637
Practice Address - Street 1:1421 3RD ST SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-5204
Practice Address - Country:US
Practice Address - Phone:540-982-2208
Practice Address - Fax:540-982-7637
Is Sole Proprietor?:No
Enumeration Date:2015-12-23
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202005895235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4978218Medicaid
VA496529Medicare UPIN