Healthcare Provider Details

I. General information

NPI: 1467512244
Provider Name (Legal Business Name): LAURIE BARNARD MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 15TH STREET WEST
RED LODGE MT
59068
US

IV. Provider business mailing address

PO BOX 1658
RED LODGE MT
59068-1658
US

V. Phone/Fax

Practice location:
  • Phone: 406-446-3755
  • Fax:
Mailing address:
  • Phone: 406-446-3755
  • Fax: 406-446-3755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number396
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: