Provider Demographics
NPI:1154187375
Name:SOH, ANNE JIN ANN
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:JIN ANN
Last Name:SOH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 SE 5TH ST
Mailing Address - Street 2:
Mailing Address - City:EAGLE GROVE
Mailing Address - State:IA
Mailing Address - Zip Code:50533-2478
Mailing Address - Country:US
Mailing Address - Phone:515-448-5123
Mailing Address - Fax:
Practice Address - Street 1:2401 DES MOINES ST
Practice Address - Street 2:
Practice Address - City:WEBSTER CITY
Practice Address - State:IA
Practice Address - Zip Code:50595-3046
Practice Address - Country:US
Practice Address - Phone:515-832-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA124116235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist