Provider Demographics
NPI:1437229705
Name:ANDERSON, CAROL BAGGOT (PHD,CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:BAGGOT
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHD,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 E FOSTER AVE
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-5722
Mailing Address - Country:US
Mailing Address - Phone:814-237-5916
Mailing Address - Fax:
Practice Address - Street 1:233 EASTERLY PKWY
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-6300
Practice Address - Country:US
Practice Address - Phone:814-237-5916
Practice Address - Fax:814-867-4066
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL001567L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist