Provider Demographics
NPI:1225420680
Name:ANTHONY, KATHRYN MARIA
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MARIA
Last Name:ANTHONY
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 1:2481 LANCASTER PIKE
Mailing Address - Street 2:
Mailing Address - City:SHILLINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19607-2378
Mailing Address - Country:US
Mailing Address - Phone:610-779-7272
Mailing Address - Fax:484-363-4056
Practice Address - Street 1:3933 PERKIOMEN AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-2756
Practice Address - Country:US
Practice Address - Phone:610-779-7272
Practice Address - Fax:484-363-4056
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005716101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional