Provider Demographics
NPI:1508410390
Name:SEIBERT, BARRY GIBSON (MS CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:BARRY
Middle Name:GIBSON
Last Name:SEIBERT
Suffix:
Gender:M
Credentials:MS CCC-SLP
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Mailing Address - Street 1:2004 N 12TH ST
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-2982
Mailing Address - Country:US
Mailing Address - Phone:970-644-3720
Mailing Address - Fax:970-644-3737
Practice Address - Street 1:2351 G RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-9641
Practice Address - Country:US
Practice Address - Phone:970-242-0920
Practice Address - Fax:970-644-3737
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COSLP0003360235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist