Barksdale, Ethelyn
Barksdale, Ethelyn is an sole proprietor health care provider with primary practice located at 2747 Dunmoore Dr , Snellville GA 30078-7356. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Barksdale, Ethelyn can be contacted via phone (770) 985-5597.Contact Information
Primary practice address
2747 Dunmoore Dr
Snellville GA 30078-7356
Phone: (770) 985-5597
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SLP001550 | Georgia |
Profile Details
| NPI number | 1164589495 |
|---|---|
| LBN Legal business name | Barksdale, Ethelyn |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 3rd, 2007 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164589495 | NPPES |
| Georgia | MEDICAID | 000563065H |
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