Provider Demographics
NPI:1598701286
Name:BARKER, CHERYL B
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:B
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:PO BOX 536
Mailing Address - Street 2:
Mailing Address - City:GRANVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43023-0536
Mailing Address - Country:US
Mailing Address - Phone:740-344-1304
Mailing Address - Fax:740-344-1305
Practice Address - Street 1:36 MCMILLEN DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-1809
Practice Address - Country:US
Practice Address - Phone:740-344-1304
Practice Address - Fax:740-344-1305
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.00976231H00000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0118909Medicaid