Healthcare Provider Details

I. General information

NPI: 1033553359
Provider Name (Legal Business Name): BARBARA TRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2013
Last Update Date: 07/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N BULLARD AVE STE C27
GOODYEAR AZ
85338-2520
US

IV. Provider business mailing address

116 S 230TH DR
BUCKEYE AZ
85326-6258
US

V. Phone/Fax

Practice location:
  • Phone: 623-986-5110
  • Fax: 480-505-3387
Mailing address:
  • Phone: 623-209-4006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA8255
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: