Provider Demographics
NPI:1588867014
Name:TANIS, CAREY ANNE (CCC MS SLP)
Entity type:Individual
Prefix:
First Name:CAREY
Middle Name:ANNE
Last Name:TANIS
Suffix:
Gender:F
Credentials:CCC MS SLP
Other - Prefix:
Other - First Name:CAREY
Other - Middle Name:ANNE
Other - Last Name:HOTCHKISS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC MS SLP
Mailing Address - Street 1:3001 EASTON AVE
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-4207
Mailing Address - Country:US
Mailing Address - Phone:610-392-4339
Mailing Address - Fax:610-865-1289
Practice Address - Street 1:3001 EASTON AVE
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-4207
Practice Address - Country:US
Practice Address - Phone:610-392-4339
Practice Address - Fax:610-865-1289
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL006411L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist