Provider Demographics
NPI:1609925148
Name:SARGENT, BARBARA JEAN (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:JEAN
Last Name:SARGENT
Suffix:
Gender:F
Credentials: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:PO BOX 531
Mailing Address - Street 2:
Mailing Address - City:LA VETA
Mailing Address - State:CO
Mailing Address - Zip Code:81055-0531
Mailing Address - Country:US
Mailing Address - Phone:719-989-1465
Mailing Address - Fax:719-695-7301
Practice Address - Street 1:615 RUSSELL AVE
Practice Address - Street 2:
Practice Address - City:WALSENBURG
Practice Address - State:CO
Practice Address - Zip Code:81089-2127
Practice Address - Country:US
Practice Address - Phone:719-695-7300
Practice Address - Fax:719-695-7301
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00814947235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist