Provider Demographics
NPI:1891814273
Name:HUTH, ANNA KATHRYN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:KATHRYN
Last Name:HUTH
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 ANNANDALE PKWY E
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-7899
Mailing Address - Country:US
Mailing Address - Phone:601-605-0893
Mailing Address - Fax:
Practice Address - Street 1:4500 I-55 NORTH
Practice Address - Street 2:HIGHLAND VILLAGE, SUITE 291
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211
Practice Address - Country:US
Practice Address - Phone:601-362-0859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS2837235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00155727Medicaid
MSS2837OtherMS BOARD OF HEALTH