Provider Demographics
NPI:1497832851
Name:CHOUDHURY, BARBARA A (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:A
Last Name:CHOUDHURY
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33165 BRIGHTON PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-6019
Mailing Address - Country:US
Mailing Address - Phone:216-337-7410
Mailing Address - Fax:
Practice Address - Street 1:33165 BRIGHTON PARK BLVD
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-6019
Practice Address - Country:US
Practice Address - Phone:216-337-7410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-8172235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0325500Medicaid
OH366518Medicare ID - Type Unspecified