Stacy Barker

Individual provider Active NPI Speech-Language Pathologist · Evanston, WY

NPI 1003032285 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1003032285
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SP-414 (WY)
Practice address
350 City View Drive
Evanston, WY 82930
Phone
(307) 789-7384
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SP-414WYMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP-414 WY Yes

Addresses

Primary practice location

350 City View Drive
Evanston, WY 82930

Mailing address

148 Gregory Ave.
Evanston, WY 82930

Other providers in Evanston, WY

All providers in Evanston, WY · Speech-Language Pathologist in Wyoming

Sources for this page

Verify at the official NPI Registry.