Provider Demographics
NPI:1578608790
Name:TROST, BARBARA JEANNE (MS CCC SPEECH ASHA)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:JEANNE
Last Name:TROST
Suffix:
Gender:F
Credentials:MS CCC SPEECH ASHA
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:RAINEY
Other - Last Name:HOULIHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1219 HOPI DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86303
Mailing Address - Country:US
Mailing Address - Phone:928-445-4220
Mailing Address - Fax:
Practice Address - Street 1:8766 EAST HWY 69
Practice Address - Street 2:HUMBOLDT UNIFIED SCHOOL DISTRICT #22 SPECIAL SERVICES
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314
Practice Address - Country:US
Practice Address - Phone:928-759-4028
Practice Address - Fax:928-759-4030
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP0225235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ583048Medicaid