Provider Demographics
NPI:1811665805
Name:BOBAL, BARBARA HOLLAND (SLP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:HOLLAND
Last Name:BOBAL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1724 FARRS GARDEN PATH
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-2066
Mailing Address - Country:US
Mailing Address - Phone:440-525-0005
Mailing Address - Fax:
Practice Address - Street 1:6046 BRECKSVILLE RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-1535
Practice Address - Country:US
Practice Address - Phone:216-232-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH14414763235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist