Provider Demographics
NPI:1316282122
Name:BARR, KATHRYN (MSP)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:
Last Name:BARR
Suffix:
Gender:F
Credentials:MSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9129 MONROE RD STE 100-105
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-2429
Mailing Address - Country:US
Mailing Address - Phone:704-847-3911
Mailing Address - Fax:704-847-2033
Practice Address - Street 1:9129 MONROE RD STE 100-105
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28270-2429
Practice Address - Country:US
Practice Address - Phone:704-847-3911
Practice Address - Fax:704-847-2033
Is Sole Proprietor?:No
Enumeration Date:2012-12-05
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10268235Z00000X
SC4973235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3842Medicaid