Provider Demographics
NPI:1871057976
Name:MOFFA, BARBARA (MS, CCC/SP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:MOFFA
Suffix:
Gender:F
Credentials:MS, CCC/SP
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:
Other - Last Name:CHECKET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC/SP
Mailing Address - Street 1:119 DUNCANNON RD
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-5624
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2225 OLD EMMORTON RD STE 210
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6123
Practice Address - Country:US
Practice Address - Phone:410-515-4900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00421235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty