Provider Demographics
NPI:1063478295
Name:HAMELIN, ANNE MARIE (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:MARIE
Last Name:HAMELIN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3267 EVERGREEN CIR
Mailing Address - Street 2:
Mailing Address - City:WALWORTH
Mailing Address - State:NY
Mailing Address - Zip Code:14568-9426
Mailing Address - Country:US
Mailing Address - Phone:315-538-8096
Mailing Address - Fax:
Practice Address - Street 1:1000 ELMWOOD AVE STE 100
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-3093
Practice Address - Country:US
Practice Address - Phone:585-271-0760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013750-1235Z00000X
NY013750235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0355344Medicaid