Provider Demographics
NPI:1790112902
Name:BARTON, VICKI D (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:D
Last Name:BARTON
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 1:4652 ROBERTS ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66226-2470
Mailing Address - Country:US
Mailing Address - Phone:913-484-4334
Mailing Address - Fax:
Practice Address - Street 1:4652 ROBERTS ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66226-2470
Practice Address - Country:US
Practice Address - Phone:913-484-4334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS844235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist