Provider Demographics
NPI:1205343373
Name:BARNES, ELAINE (SLP)
Entity type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 COURTHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISA
Mailing Address - State:VA
Mailing Address - Zip Code:23093-3329
Mailing Address - Country:US
Mailing Address - Phone:540-967-1347
Mailing Address - Fax:
Practice Address - Street 1:2055 COURTHOUSE RD
Practice Address - Street 2:
Practice Address - City:LOUISA
Practice Address - State:VA
Practice Address - Zip Code:23093-3329
Practice Address - Country:US
Practice Address - Phone:540-967-1347
Practice Address - Fax:540-967-1347
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-10
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2203000211235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist