Provider Demographics
NPI:1154521656
Name:DENSON, ANNA HAINES (MA/CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:HAINES
Last Name:DENSON
Suffix:
Gender:F
Credentials:MA/CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11807 BROADWATER LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-6702
Mailing Address - Country:US
Mailing Address - Phone:704-504-0717
Mailing Address - Fax:
Practice Address - Street 1:11807 BROADWATER LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-6702
Practice Address - Country:US
Practice Address - Phone:704-504-0717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1993235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist