Provider Demographics
NPI:1376005165
Name:MAGDALEN SPRINKLE, ANN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:MAGDALEN SPRINKLE
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 1:748 S MEADOWS PKWY STE A9 #234
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-4841
Mailing Address - Country:US
Mailing Address - Phone:775-234-8613
Mailing Address - Fax:855-753-0047
Practice Address - Street 1:1715 MONTE VISTA DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-5411
Practice Address - Country:US
Practice Address - Phone:752-348-6137
Practice Address - Fax:855-753-0047
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-02
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-2484235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty