Provider Demographics
NPI:1902942899
Name:SIEGEL, BARBARA GAIL (MSCCC SP)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:GAIL
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:MSCCC SP
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:
Other - Last Name:HEILBRUNN SIEGEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:9048 YELLOWWOOD CT
Mailing Address - Street 2:
Mailing Address - City:INDPLS
Mailing Address - State:IN
Mailing Address - Zip Code:46260
Mailing Address - Country:US
Mailing Address - Phone:317-432-0584
Mailing Address - Fax:317-872-2080
Practice Address - Street 1:MARION COUNTY INDPLS DR
Practice Address - Street 2:
Practice Address - City:INDPLS
Practice Address - State:IN
Practice Address - Zip Code:46260
Practice Address - Country:US
Practice Address - Phone:317-432-0584
Practice Address - Fax:317-872-2080
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN00971341235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
200718780AOther1ST STEPS PROVIDER