Provider Demographics
NPI:1649501271
Name:BOTHE, ANNE KATHERINE (MA, PHD, CCC-SLP)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:KATHERINE
Last Name:BOTHE
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Gender:F
Credentials:MA, PHD, CCC-SLP
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Mailing Address - Street 1:516 ADERHOLD HL
Mailing Address - Street 2:UNIV OF GEORGIA
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30602-0001
Mailing Address - Country:US
Mailing Address - Phone:706-542-0436
Mailing Address - Fax:706-542-5348
Practice Address - Street 1:516 ADERHOLD HL
Practice Address - Street 2:UNIV OF GEORGIA
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30602-0001
Practice Address - Country:US
Practice Address - Phone:706-542-0436
Practice Address - Fax:706-542-5348
Is Sole Proprietor?:No
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GASLP006211235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist