Provider Demographics
NPI:1588713044
Name:HARBOUR-TONN, ANNE MARIE (SLP)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:MARIE
Last Name:HARBOUR-TONN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4102 N ROXBORO ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2122
Mailing Address - Country:US
Mailing Address - Phone:919-595-2000
Mailing Address - Fax:919-595-2190
Practice Address - Street 1:4102 N ROXBORO ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2122
Practice Address - Country:US
Practice Address - Phone:919-595-2000
Practice Address - Fax:919-595-2190
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1359235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7411479Medicaid
NC1203LOtherBLUE CROSS