Provider Demographics
NPI:1790948602
Name:ANSLOW-MYERS, BARBARA ELLEN
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ELLEN
Last Name:ANSLOW-MYERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:ELLEN
Other - Last Name:ANSLOW-MYERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS SLP-CCC
Mailing Address - Street 1:530 LITTLE COVE LANE
Mailing Address - Street 2:
Mailing Address - City:LAKE WYLIE
Mailing Address - State:SC
Mailing Address - Zip Code:29710
Mailing Address - Country:US
Mailing Address - Phone:518-368-5816
Mailing Address - Fax:
Practice Address - Street 1:530 LITTLE COVE LANE
Practice Address - Street 2:
Practice Address - City:LAKE WYLIE
Practice Address - State:SC
Practice Address - Zip Code:29710
Practice Address - Country:US
Practice Address - Phone:518-368-5816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4314235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist