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General NPI Number Information
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NPI Number | 1609925148
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Entity Type | Individual
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Provider Name | BARBARA JEAN SARGENT CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 05/13/2021
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Provider Practice Location Address
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Address Line | 615 RUSSELL AVE
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City | WALSENBURG
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State | CO
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Zip | 81089-2127
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Country | US
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Telephone | 719-695-7300
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Fax | 719-695-7301
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Provider Business Mailing Address
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Address Line | PO BOX 531
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City | LA VETA
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State | CO
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Zip | 81055-0531
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Country | US
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Telephone | 719-989-1465
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Fax | 719-695-7301
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 00814947
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License Number State | CO
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