Provider Demographics
NPI:1164683322
Name:ANTHONY, KATIE MARIA (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:MARIA
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 RUTGERS DR
Mailing Address - Street 2:
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-4120
Mailing Address - Country:US
Mailing Address - Phone:412-213-3051
Mailing Address - Fax:
Practice Address - Street 1:817 RUTGERS DR
Practice Address - Street 2:
Practice Address - City:ALLISON PARK
Practice Address - State:PA
Practice Address - Zip Code:15101-4120
Practice Address - Country:US
Practice Address - Phone:412-213-3051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009080235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist