Provider Demographics
NPI:1679527584
Name:PETERS, BARBARA ANN (MS,CCC/SLP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:PETERS
Suffix:
Gender:F
Credentials:MS,CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 TABERNASH DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-2486
Mailing Address - Country:US
Mailing Address - Phone:970-663-0226
Mailing Address - Fax:970-663-0226
Practice Address - Street 1:1113 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-4722
Practice Address - Country:US
Practice Address - Phone:970-498-4077
Practice Address - Fax:980-667-8383
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO23635070Medicaid