Provider Demographics
NPI:1528285673
Name:LOGUE, BARBARA HORTON (CCC-SLP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:HORTON
Last Name:LOGUE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 W COLONY PL
Mailing Address - Street 2:STE. 110
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-5594
Mailing Address - Country:US
Mailing Address - Phone:919-493-2392
Mailing Address - Fax:919-493-7733
Practice Address - Street 1:21 W COLONY PL
Practice Address - Street 2:STE. 110
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-5594
Practice Address - Country:US
Practice Address - Phone:919-493-2392
Practice Address - Fax:919-493-7733
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC465235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist