Provider Demographics
NPI:1871346221
Name:ALBERS, ANNELISE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANNELISE
Middle Name:
Last Name:ALBERS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5010 31ST AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417-1406
Mailing Address - Country:US
Mailing Address - Phone:414-366-0694
Mailing Address - Fax:
Practice Address - Street 1:5010 31ST AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417-1406
Practice Address - Country:US
Practice Address - Phone:414-366-0694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6118235Z00000X
MN10296235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist