Provider Demographics
NPI:1548669187
Name:NORTHRUP, BARBARA (MA/CCC)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:NORTHRUP
Suffix:
Gender:F
Credentials:MA/CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6422 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-2358
Mailing Address - Country:US
Mailing Address - Phone:614-864-6620
Mailing Address - Fax:614-864-6690
Practice Address - Street 1:6422 E MAIN ST
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-2358
Practice Address - Country:US
Practice Address - Phone:614-864-6620
Practice Address - Fax:614-864-6690
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP2147235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist