Provider Demographics
NPI:1437330727
Name:ANTHONY-HIGLEY, CARON ANGELA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CARON
Middle Name:ANGELA
Last Name:ANTHONY-HIGLEY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 WATERFORD ST
Mailing Address - Street 2:
Mailing Address - City:EDINBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16412-2315
Mailing Address - Country:US
Mailing Address - Phone:814-734-5610
Mailing Address - Fax:
Practice Address - Street 1:252 WATERFORD ST
Practice Address - Street 2:
Practice Address - City:EDINBORO
Practice Address - State:PA
Practice Address - Zip Code:16412-2315
Practice Address - Country:US
Practice Address - Phone:814-734-5610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL006365L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019297280002Medicaid