Antony, Mary
Antony, Mary is an individual health care provider with primary practice located at 1218 79Th St , Kenosha WI 53143-6111. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Antony, Mary can be contacted via phone (262) 658-9500.Contact Information
Primary practice address
1218 79Th St
Kenosha WI 53143-6111
Phone: (262) 658-9500
Fax: (262) 658-9621
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 285-154 | Wisconsin |
Profile Details
| NPI number | 1306019625 |
|---|---|
| LBN Legal business name | Antony, Mary |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 8th, 2008 |
| Last updated | Apr 8th, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306019625 | NPPES |
| Wisconsin | MEDICAID | 42745100 |
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