Provider Demographics
NPI:1639296551
Name:RAZZANO, BARBARA (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:RAZZANO
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 1:4721 GROVETON WAY
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-3823
Mailing Address - Country:US
Mailing Address - Phone:314-845-9758
Mailing Address - Fax:
Practice Address - Street 1:4721 GROVETON WAY
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-3823
Practice Address - Country:US
Practice Address - Phone:314-845-9758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.006796235Z00000X
MO2004027798235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist