Provider Demographics
NPI:1104054956
Name:GAISER, BARBARA CONROY (CCC, SLP)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:CONROY
Last Name:GAISER
Suffix:
Gender:F
Credentials:CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15241 SAM SNEAD LANE
Mailing Address - Street 2:
Mailing Address - City:N. FT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33917
Mailing Address - Country:US
Mailing Address - Phone:239-731-6000
Mailing Address - Fax:239-731-6000
Practice Address - Street 1:1650 MEDICAL LANE
Practice Address - Street 2:SUITE #1
Practice Address - City:FT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-1116
Practice Address - Country:US
Practice Address - Phone:239-277-9818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 1428235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist