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NPI Code Detail

MEDICARE: ANITA HACKETT CCC-SLP

MEDICARE: ANITA HACKETT 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
1235Z00000XSpeech-Language PathologistSLP0457AZ

General Provider Information

NPI Number : 1902206451
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANITA HACKETT CCC-SLP
Provider Business Mailing Address
First Line : 1190 E MISSOURI AVE STE 100
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-2719
Country : US
Telephone Number : 602-393-0520
Fax Number :
Provider Business Practice Location Address
First Line : 1190 E MISSOURI AVE STE 100
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-2719
Country : US
Telephone Number : 602-393-0520
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2014
Last Update Date : 09/02/2014

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Directions to “ ANITA HACKETT CCC-SLP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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