Provider Demographics
NPI:1245576479
Name:ABINANTI, ANNIE
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:
Last Name:ABINANTI
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ANNE
Other - Middle Name:
Other - Last Name:ABINANTI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6927 OLD SEWARD HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99518-2283
Mailing Address - Country:US
Mailing Address - Phone:910-483-8331
Mailing Address - Fax:910-483-8335
Practice Address - Street 1:6927 OLD SEWARD HWY STE 100
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518-2283
Practice Address - Country:US
Practice Address - Phone:910-483-8331
Practice Address - Fax:910-483-8335
Is Sole Proprietor?:No
Enumeration Date:2012-12-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10227235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1659331Medicaid