Provider Demographics
NPI:1457616302
Name:KOTZIN, BARBARA (MA, MED)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:
Last Name:KOTZIN
Suffix:
Gender:F
Credentials:MA, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 CENTRAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:CHELTENHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19012
Mailing Address - Country:US
Mailing Address - Phone:215-663-0505
Mailing Address - Fax:
Practice Address - Street 1:609 CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:CHELTENHAM
Practice Address - State:PA
Practice Address - Zip Code:19012
Practice Address - Country:US
Practice Address - Phone:215-663-0505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL001162L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist