Provider Demographics
NPI:1235297532
Name:HENNESSY, ANN E (MA CCC-A)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:E
Last Name:HENNESSY
Suffix:
Gender:F
Credentials:MA CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 APALACHEE PKWY
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-3055
Mailing Address - Country:US
Mailing Address - Phone:850-942-4007
Mailing Address - Fax:850-942-7927
Practice Address - Street 1:1500 APALACHEE PKWY
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-3055
Practice Address - Country:US
Practice Address - Phone:850-942-4007
Practice Address - Fax:850-942-7927
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY724231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist