Provider Demographics
NPI:1639681620
Name:BARKER, CAITLIN ROBERTS (SLP)
Entity type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:ROBERTS
Last Name:BARKER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:CAITLIN
Other - Last Name:BARKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:150 LAKESHORE DR S
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661-5124
Mailing Address - Country:US
Mailing Address - Phone:256-453-0249
Mailing Address - Fax:
Practice Address - Street 1:102 SANDERS ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-2418
Practice Address - Country:US
Practice Address - Phone:256-431-4223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-30
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
AL2521235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty