Provider Demographics
NPI:1871997346
Name:LANTZ, ANNE KRISTEN (MHS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:KRISTEN
Last Name:LANTZ
Suffix:
Gender:F
Credentials:MHS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3023 S FORT AVE
Mailing Address - Street 2:STE B
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-4217
Mailing Address - Country:US
Mailing Address - Phone:573-248-6599
Mailing Address - Fax:
Practice Address - Street 1:639 W CHESTNUT EXPY
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65802-3935
Practice Address - Country:US
Practice Address - Phone:417-523-7500
Practice Address - Fax:417-523-7695
Is Sole Proprietor?:No
Enumeration Date:2014-10-13
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist