Healthcare Provider Details

I. General information

NPI: 1740114925
Provider Name (Legal Business Name): MADELYNNE VIOLET BARNETT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22864 PERIMETER LANE
LEBANON MO
65536
US

IV. Provider business mailing address

439 CREEK SIDE PL
MARSHFIELD MO
65706-1182
US

V. Phone/Fax

Practice location:
  • Phone: 417-532-6528
  • Fax:
Mailing address:
  • Phone: 417-322-0177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2026023066
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: