Provider Demographics
NPI:1629079868
Name:MCCARTY, ANNE C (AUD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:C
Last Name:MCCARTY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2763 CLIFFROSE DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87122-1229
Mailing Address - Country:US
Mailing Address - Phone:505-328-7387
Mailing Address - Fax:
Practice Address - Street 1:2611 EUBANK BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-1312
Practice Address - Country:US
Practice Address - Phone:505-298-6752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1142231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMQ6945Medicaid
NMQ6945Medicaid