Provider Demographics
NPI:1245362771
Name:KOLOM, BARBARA JEAN (MA, CCC,SLP)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:JEAN
Last Name:KOLOM
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 1:8335 W 121ST ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-1241
Mailing Address - Country:US
Mailing Address - Phone:913-339-6109
Mailing Address - Fax:
Practice Address - Street 1:8335 W 121ST ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-1241
Practice Address - Country:US
Practice Address - Phone:913-339-6109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS252235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist