Provider Demographics
NPI:1861968018
Name:BARBA, JAIME AKIKO-IWAOKA (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:AKIKO-IWAOKA
Last Name:BARBA
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 ANTELOPE VILLAGE CIR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-2273
Mailing Address - Country:US
Mailing Address - Phone:702-755-7798
Mailing Address - Fax:
Practice Address - Street 1:2441 W HORIZON RIDGE PKWY STE 114
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-5789
Practice Address - Country:US
Practice Address - Phone:702-755-7798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP1144235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist