Provider Demographics
NPI:1780724351
Name:CARROLL, ANITA M (MS, CCC-A)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:M
Last Name:CARROLL
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1829 E FRANKLIN ST
Mailing Address - Street 2:SUITE 200-A
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-5861
Mailing Address - Country:US
Mailing Address - Phone:919-403-3277
Mailing Address - Fax:919-403-3277
Practice Address - Street 1:1829 E FRANKLIN ST
Practice Address - Street 2:SUITE 200-A
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-5861
Practice Address - Country:US
Practice Address - Phone:919-403-3277
Practice Address - Fax:919-403-3277
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1594231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist