Provider Demographics
NPI:1952816019
Name:CARTWRIGHT, ANITA GALE
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:GALE
Last Name:CARTWRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 COUNTY ROAD 435
Mailing Address - Street 2:
Mailing Address - City:TENAHA
Mailing Address - State:TX
Mailing Address - Zip Code:75974-6344
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:123 COUNTY ROAD #435
Practice Address - Street 2:
Practice Address - City:TENAHA
Practice Address - State:TX
Practice Address - Zip Code:75974
Practice Address - Country:US
Practice Address - Phone:936-332-6671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-11
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2387235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist