Provider Demographics
NPI:1619467156
Name:TUCKER, BARBARA B (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:B
Last Name:TUCKER
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 1:7351 WOODSTONE CT
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20187-7938
Mailing Address - Country:US
Mailing Address - Phone:540-272-0983
Mailing Address - Fax:
Practice Address - Street 1:CEDAR LEE MIDDLE SCHOOL
Practice Address - Street 2:11138 MARSH ROAD
Practice Address - City:BEALETON
Practice Address - State:VA
Practice Address - Zip Code:22172
Practice Address - Country:US
Practice Address - Phone:540-422-7430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-10
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2203000356235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist