Provider Demographics
NPI:1427590660
Name:VIALL, ANNE GALLACHER (MA SPEECH PATHOLOGY)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:GALLACHER
Last Name:VIALL
Suffix:
Gender:F
Credentials:MA SPEECH PATHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 WOODBINE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-4519
Mailing Address - Country:US
Mailing Address - Phone:513-479-4692
Mailing Address - Fax:
Practice Address - Street 1:750 WOODBINE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-4519
Practice Address - Country:US
Practice Address - Phone:513-479-4692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP. 2242235Z00000X
OHOS1009058235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist