Provider Demographics
NPI:1740328392
Name:TAYLOR, BARBARA BERRY (MA)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:BERRY
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1731 SW 44TH ST
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-6202
Mailing Address - Country:US
Mailing Address - Phone:239-541-8682
Mailing Address - Fax:239-471-7767
Practice Address - Street 1:1731 SW 44TH ST
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-6202
Practice Address - Country:US
Practice Address - Phone:239-541-8682
Practice Address - Fax:239-471-7767
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1213235Z00000X
FLSA 9955235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist