MEDICARE: MISS ALICIA BESS ANITA NATHISON M.A., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	7293	NC

General Provider Information

NPI Number	:	1700839867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ALICIA BESS ANITA NATHISON M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	10114 WHITEMARK LN
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27511-7109
Country	:	US
Telephone Number	:	919-467-8540
Fax Number	:

Provider Business Practice Location Address
First Line	:	319 CHAPANOKE RD
Second Line	:	SUITE 101
City	:	RALEIGH
State	:	NC
Zip	:	27603-3433
Country	:	US
Telephone Number	:	919-662-4600
Fax Number	:	919-662-4473

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	07/08/2007

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