Provider Demographics
NPI:1871033449
Name:MARTIN, BARBARA (SPA)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:SPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2056 PALOMA ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-4821
Mailing Address - Country:US
Mailing Address - Phone:626-532-5388
Mailing Address - Fax:
Practice Address - Street 1:3245 N VERDUGO RD
Practice Address - Street 2:301
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-1641
Practice Address - Country:US
Practice Address - Phone:818-957-2766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12082355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant