Provider Demographics
NPI:1811391592
Name:BARBOUR, ANNABELLE (M ED, CF-SLP)
Entity type:Individual
Prefix:
First Name:ANNABELLE
Middle Name:
Last Name:BARBOUR
Suffix:
Gender:F
Credentials:M ED, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 SCHROER RD
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31605-7013
Mailing Address - Country:US
Mailing Address - Phone:229-244-3552
Mailing Address - Fax:
Practice Address - Street 1:3801 SCHROER RD
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31605-7013
Practice Address - Country:US
Practice Address - Phone:229-244-3552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPCET002117235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist