Provider Demographics
NPI:1366784548
Name:BARKER, LORI
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:BARKER
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 1:209 DALE TERRANCE
Mailing Address - Street 2:
Mailing Address - City:CLARKVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042
Mailing Address - Country:US
Mailing Address - Phone:606-584-1169
Mailing Address - Fax:800-584-7323
Practice Address - Street 1:209 DALE TERRANCE
Practice Address - Street 2:
Practice Address - City:CLARKVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042
Practice Address - Country:US
Practice Address - Phone:606-584-1169
Practice Address - Fax:800-584-7323
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3548235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist