Provider Demographics
NPI:1245682624
Name:BARCELLOS, STEFANY
Entity type:Individual
Prefix:
First Name:STEFANY
Middle Name:
Last Name:BARCELLOS
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 1:11 LORIN DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01887-2898
Mailing Address - Country:US
Mailing Address - Phone:978-944-3141
Mailing Address - Fax:
Practice Address - Street 1:11 LORIN DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:MA
Practice Address - Zip Code:01887-2898
Practice Address - Country:US
Practice Address - Phone:978-944-3141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-08
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist