MEDICARE: MRS. BARBARA LYNN HARTSHORN MS CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	7411	NC

General Provider Information

NPI Number	:	1962579557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BARBARA LYNN HARTSHORN MS CCC-SLP

Provider Business Mailing Address
First Line	:	1031 ATHERTON DR
Second Line	:
City	:	INDIAN TRAIL
State	:	NC
Zip	:	28079-5662
Country	:	US
Telephone Number	:	704-578-3334
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 W MATTHEWS ST STE 203
Second Line	:
City	:	MATTHEWS
State	:	NC
Zip	:	28105-1310
Country	:	US
Telephone Number	:	704-846-0262
Fax Number	:	704-846-2958

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	11/04/2021

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