Provider Demographics
NPI:1295378990
Name:MENHARDT, ANNA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:
Last Name:MENHARDT
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 S PINE ST
Mailing Address - Street 2:
Mailing Address - City:WALHALLA
Mailing Address - State:SC
Mailing Address - Zip Code:29691-2146
Mailing Address - Country:US
Mailing Address - Phone:413-663-4385
Mailing Address - Fax:
Practice Address - Street 1:414 S PINE ST
Practice Address - Street 2:
Practice Address - City:WALHALLA
Practice Address - State:SC
Practice Address - Zip Code:29691-2146
Practice Address - Country:US
Practice Address - Phone:361-660-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-25
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6984235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist