Provider Demographics
NPI:1598952715
Name:BARKER, SUSAN M (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:M
Last Name:BARKER
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 1:5851 CLARK STATION RD
Mailing Address - Street 2:
Mailing Address - City:FINCHVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40022
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5851 CLARK STATION ROAD
Practice Address - Street 2:
Practice Address - City:FINCHVILLE
Practice Address - State:KY
Practice Address - Zip Code:40022
Practice Address - Country:US
Practice Address - Phone:502-931-3974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH8007235Z00000X
KYSLPLPA00216196235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist