Provider Demographics
NPI:1659616191
Name:SYLVESTER, BETSY ANNE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BETSY
Middle Name:ANNE
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:BETSY
Other - Middle Name:ANNE
Other - Last Name:FAGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6533 NW MELODY CT
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64152-3374
Mailing Address - Country:US
Mailing Address - Phone:816-682-8650
Mailing Address - Fax:
Practice Address - Street 1:6533 NW MELODY CT
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MO
Practice Address - Zip Code:64152-3374
Practice Address - Country:US
Practice Address - Phone:816-682-8650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008014709235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist