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NPI Code Detail

MEDICARE: BARBARA F. RANDANT M.S. CCC-A

MEDICARE: BARBARA F. RANDANT M.S. CCC-A
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1231H00000XAudiologist147.000170IL
2235Z00000XSpeech-Language Pathologist146.002399IL

General Provider Information

NPI Number : 1235379140
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA F. RANDANT M.S. CCC-A
Provider Business Mailing Address
First Line : 1515 MAIN ST
Second Line :
City : HIGHLAND
State : IL
Zip : 62249-1656
Country : US
Telephone Number : 618-651-2720
Fax Number : 618-651-2722
Provider Business Practice Location Address
First Line : 1515 MAIN ST
Second Line :
City : HIGHLAND
State : IL
Zip : 62249-1656
Country : US
Telephone Number : 618-651-2720
Fax Number : 618-651-2722
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2009
Last Update Date : 03/05/2009

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