Mary Balfour, M.S., CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Dryden, NY

NPI 1942589015 · NPPES record last updated May 22, 2014

Key facts

NPI
1942589015
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
021218-1 (NY)
Practice address
36 Union Street
Dryden, NY 13053
Phone
(607) 844-8694
Fax
(607) 844-9449
NPI assigned
Aug 8, 2011
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
021218-1NYMDMedical Physician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 021218-1 NY Yes

Addresses

Primary practice location

36 Union Street
Dryden, NY 13053

Mailing address

36 Union Street
Dryden, NY 13053-1200
Phone (607) 844-8694

Other providers in Dryden, NY

All providers in Dryden, NY · Speech-Language Pathologist in New York

Sources for this page

Verify at the official NPI Registry.