Provider Demographics
NPI:1972680403
Name:RYDER, ANNE (MA CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:
Last Name:RYDER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 LOWELL ST
Mailing Address - Street 2:IRONSTONE FARM THERAPY
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-5305
Mailing Address - Country:US
Mailing Address - Phone:978-475-4056
Mailing Address - Fax:978-475-4046
Practice Address - Street 1:450 LOWELL ST
Practice Address - Street 2:IRONSTONE FARM THERAPY
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-5305
Practice Address - Country:US
Practice Address - Phone:978-475-4056
Practice Address - Fax:978-475-4046
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6762235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MASP0153OtherBCBS SPEECH PATHOLOGIST
MA620733OtherTUFTS GROUP
MASG0013OtherBCBS GROUP
MA1942270574OtherNPI GROUP
MA3668706OtherAETNA
MA478889OtherTUFTS INDIVIDUAL
MA626557OtherHPHC
MASP0153OtherBCBS SPEECH PATHOLOGIST