Provider Demographics
NPI:1568770618
Name:VEREB, ANITA FAY (PHD)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:FAY
Last Name:VEREB
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3621 SOUTH STATE STREET
Mailing Address - Street 2:700 KMS PLACE
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108
Mailing Address - Country:US
Mailing Address - Phone:734-936-2047
Mailing Address - Fax:
Practice Address - Street 1:475 MARKET PL
Practice Address - Street 2:BLDG 1, SUITE A
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-1649
Practice Address - Country:US
Practice Address - Phone:734-998-8119
Practice Address - Fax:734-998-8122
Is Sole Proprietor?:No
Enumeration Date:2010-09-22
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000251231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist