Healthcare Provider Details

I. General information

NPI: 1023091790
Provider Name (Legal Business Name): DEANNA L. BAROWSKI MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2005
Last Update Date: 10/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 NORTHVIEW DR
HIGHLAND IL
62249-1077
US

IV. Provider business mailing address

95 NORTHVIEW DR
HIGHLAND IL
62249-1077
US

V. Phone/Fax

Practice location:
  • Phone: 618-651-0849
  • Fax: 618-651-0849
Mailing address:
  • Phone: 618-977-9759
  • Fax: 888-972-3587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSPP109415
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146004266
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License NumberDB94530602P
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: