Provider Demographics
NPI:1104122597
Name:KNIGHTON, ANTHONY GLENN (MS CCC SLP)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:GLENN
Last Name:KNIGHTON
Suffix:
Gender:M
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S MAIN ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-6848
Mailing Address - Country:US
Mailing Address - Phone:501-278-9904
Mailing Address - Fax:501-278-9906
Practice Address - Street 1:400 S MAIN ST
Practice Address - Street 2:SUITE 500
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-6848
Practice Address - Country:US
Practice Address - Phone:501-278-9904
Practice Address - Fax:501-278-9906
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-01
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP1832235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist