Basic Information
| Provider Information | |||||||||
| NPI: | 1639649965 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HERRMANN | ||||||||
| FirstName: | ANN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10516 WHITE LAKE CT | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336261940 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8134808593 | ||||||||
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| Practice Location | |||||||||
| Address1: | 16702 N DALE MABRY HWY | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336181055 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8139082333 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/29/2018 | ||||||||
| LastUpdateDate: | 11/29/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SA4788 | FL | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.