Provider Demographics
NPI:1972733129
Name:PRETTO, ANEESHA PATRICE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANEESHA
Middle Name:PATRICE
Last Name:PRETTO
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 1:2965 PHARR COURT SOUTH NW APT 703
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-2142
Mailing Address - Country:US
Mailing Address - Phone:919-593-3381
Mailing Address - Fax:
Practice Address - Street 1:1901 CENTURY BLVD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-3300
Practice Address - Country:US
Practice Address - Phone:404-633-8911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP007507235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist