Provider Demographics
NPI:1609270727
Name:BARNES, ADAM (SLP)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:BARNES
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7819 STATE ROUTE 19
Mailing Address - Street 2:
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833-9654
Mailing Address - Country:US
Mailing Address - Phone:419-947-1900
Mailing Address - Fax:419-947-7545
Practice Address - Street 1:7819 STATE ROUTE 19
Practice Address - Street 2:
Practice Address - City:GALION
Practice Address - State:OH
Practice Address - Zip Code:44833-9654
Practice Address - Country:US
Practice Address - Phone:419-947-1900
Practice Address - Fax:419-947-7545
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2015133235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist