Individual
ANITA BAKULA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
35 REFERENDUM DR NE, BOLIVIA, NC 28422-7578
(910) 406-5100
(866) 293-0649
Mailing address
1103 CLOVERDALE CT, WINNABOW, NC 28479-5676
(910) 406-5100
(866) 293-0649
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12962
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
886830
AHCCCS
AZ
Enumeration date
10/04/2006
Last updated
03/31/2026
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