Provider Demographics
NPI:1306607916
Name:BARGE, KAILYN
Entity type:Individual
Prefix:
First Name:KAILYN
Middle Name:
Last Name:BARGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2134 PROVIDENCE RD # 3
Mailing Address - Street 2:
Mailing Address - City:NORTHBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01534-1437
Mailing Address - Country:US
Mailing Address - Phone:508-579-4729
Mailing Address - Fax:
Practice Address - Street 1:333 TURNPIKE RD
Practice Address - Street 2:
Practice Address - City:SOUTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01772-1755
Practice Address - Country:US
Practice Address - Phone:508-898-2688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASPA1002282355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant