Provider Demographics
NPI:1093925711
Name:WILLIAMS-BARTH, MICHAELA
Entity Type:Individual
Prefix:MRS
First Name:MICHAELA
Middle Name:
Last Name:WILLIAMS-BARTH
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 1:103 FIFERS LN
Mailing Address - Street 2:
Mailing Address - City:BOXBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01719-2130
Mailing Address - Country:US
Mailing Address - Phone:978-266-9506
Mailing Address - Fax:
Practice Address - Street 1:103 FIFERS LN
Practice Address - Street 2:
Practice Address - City:BOXBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01719-2130
Practice Address - Country:US
Practice Address - Phone:978-266-9506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASP3211-SL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist