Healthcare Provider Details

I. General information

NPI: 1265944920
Provider Name (Legal Business Name): BARBARA MICHELLE GAGE MA, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2017
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 KEYSTONE DR
OXFORD MS
38655-0237
US

IV. Provider business mailing address

9366 DOSS FERRY LN
KIMBERLY AL
35091-2030
US

V. Phone/Fax

Practice location:
  • Phone: 205-249-8890
  • Fax:
Mailing address:
  • Phone: 205-249-8890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number31045
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP.0004715
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberS-4403
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: