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General NPI Number Information
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NPI Number | 1235645128
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Entity Type | Individual
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Provider Name | ANN BONNER MCCARTHY MS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 12/14/2017
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 373 MAIN ST UNIT B
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City | NEW CANAAN
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State | CT
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Zip | 06840-5903
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Country | US
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Telephone | 917-843-7134
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Fax |
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Provider Business Mailing Address
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Address Line | 340 E 86TH ST APT 18
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City | NEW YORK
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State | NY
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Zip | 10028-4661
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Country | US
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Telephone | 484-832-3498
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 026814
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License Number State | NY
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