Provider Demographics
NPI:1316799059
Name:ROLF, ANNALEE L
Entity type:Individual
Prefix:
First Name:ANNALEE
Middle Name:L
Last Name:ROLF
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 1:999 S HARWOOD ST APT 214
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-6167
Mailing Address - Country:US
Mailing Address - Phone:913-259-8175
Mailing Address - Fax:
Practice Address - Street 1:999 S HARWOOD ST APT 214
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-6167
Practice Address - Country:US
Practice Address - Phone:913-259-8175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2024-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX121394235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist