Provider Demographics
NPI:1063053296
Name:ESCHER, ANN MARIE (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:MARIE
Last Name:ESCHER
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 1:1052 27TH AVE SE APT A
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-2728
Mailing Address - Country:US
Mailing Address - Phone:563-203-0633
Mailing Address - Fax:
Practice Address - Street 1:561 7TH ST W
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-3009
Practice Address - Country:US
Practice Address - Phone:563-203-0633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-29
Last Update Date:2019-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10245235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist