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General NPI Number Information
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NPI Number | 1619970282
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Entity Type | Individual
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Provider Name | BARBARA C STREET M.A., CCC-A
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Gender | Female
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 12/28/2009
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Provider Practice Location Address
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Address Line | 184 CLEAR CREEK DR STE 1
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City | ASHLAND
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State | OR
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Zip | 97520-1977
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Country | US
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Telephone | 541-201-3201
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Fax | 541-201-3202
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Provider Business Mailing Address
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Address Line | 184 CLEAR CREEK DR STE 1
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City | ASHLAND
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State | OR
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Zip | 97520-1977
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Country | US
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Telephone | 541-201-3201
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Fax | 541-201-3202
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 20555
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License Number State | OR
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