Provider Demographics
NPI:1851661409
Name:PERRY, BARBARA ANN (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:PERRY
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PLEASANT AVENUE
Mailing Address - Street 2:
Mailing Address - City:SCHAGHTICOKE
Mailing Address - State:NY
Mailing Address - Zip Code:12154-3113
Mailing Address - Country:US
Mailing Address - Phone:518-753-4491
Mailing Address - Fax:
Practice Address - Street 1:2 PLEASANT AVENUE
Practice Address - Street 2:
Practice Address - City:SCHAGHTICOKE
Practice Address - State:NY
Practice Address - Zip Code:12154-3113
Practice Address - Country:US
Practice Address - Phone:518-753-4491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007625-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist