Provider Demographics
NPI:1972220309
Name:JAEGER, BARBARA JEAN (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:JEAN
Last Name:JAEGER
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 1:2675 COURT DR
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-1478
Mailing Address - Country:US
Mailing Address - Phone:704-824-4999
Mailing Address - Fax:704-824-3999
Practice Address - Street 1:300 MARKET ST STE 110
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-0448
Practice Address - Country:US
Practice Address - Phone:984-528-8787
Practice Address - Fax:984-246-1223
Is Sole Proprietor?:No
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15064235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist