Provider Demographics
NPI:1902039639
Name:PUGH, BARBARA ANN (MS, CCC/SLP, ATP)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:PUGH
Suffix:
Gender:F
Credentials:MS, CCC/SLP, ATP
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:ANN
Other - Last Name:BURCHETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5659 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:THELMA
Mailing Address - State:KY
Mailing Address - Zip Code:41260
Mailing Address - Country:US
Mailing Address - Phone:606-788-7080
Mailing Address - Fax:606-788-7076
Practice Address - Street 1:5659 MAIN STREET
Practice Address - Street 2:
Practice Address - City:THELMA
Practice Address - State:KY
Practice Address - Zip Code:41260
Practice Address - Country:US
Practice Address - Phone:606-788-7080
Practice Address - Fax:606-788-7076
Is Sole Proprietor?:No
Enumeration Date:2009-08-28
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1151235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist