Provider Demographics
NPI:1770127680
Name:BALCOM, ANI
Entity type:Individual
Prefix:
First Name:ANI
Middle Name:
Last Name:BALCOM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 SPRUCE AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-2148
Mailing Address - Country:US
Mailing Address - Phone:302-557-3700
Mailing Address - Fax:
Practice Address - Street 1:110 HOPEWELL RD STE 100
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-1047
Practice Address - Country:US
Practice Address - Phone:484-224-5885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist