Provider Demographics
NPI:1346088598
Name:DE SORDI, ANNA
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:DE SORDI
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 1:201 N 46TH ST APT 1106
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68132-3258
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7802 HASCALL ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-3468
Practice Address - Country:US
Practice Address - Phone:402-709-9784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-19
Last Update Date:2024-08-30
Deactivation Date:2024-07-19
Deactivation Code:
Reactivation Date:2024-08-27
Provider Licenses
StateLicense IDTaxonomies
NE1035235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist