Provider Demographics
NPI:1740320340
Name:LIVINGSTON, BARCLAY P (CCC-SLP)
Entity type:Individual
Prefix:
First Name:BARCLAY
Middle Name:P
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:BARCLAY
Other - Middle Name:L
Other - Last Name:HAMMOND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:808 W SCHUBERT ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-2519
Mailing Address - Country:US
Mailing Address - Phone:361-443-5507
Mailing Address - Fax:
Practice Address - Street 1:518 W PEACH ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-3136
Practice Address - Country:US
Practice Address - Phone:361-443-5507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17721235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist