Abby Anthony

Individual provider Active NPI Speech-Language Pathologist · Derby, KS

NPI 1376092270 · NPPES record last updated Oct 3, 2016

Key facts

NPI
1376092270
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
3086 (KS)
Practice address
2019 N Forest Park St
Derby, KS 67037-3126
Phone
(316) 207-1817
NPI assigned
Oct 3, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
3086KSMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3086 KS Yes

Addresses

Primary practice location

2019 N Forest Park St
Derby, KS 67037-3126

Mailing address

2019 N Forest Park St
Derby, KS 67037-3126
Phone (316) 207-1817

Other providers in Derby, KS

All providers in Derby, KS · Speech-Language Pathologist in Kansas

Sources for this page

Verify at the official NPI Registry.