Provider Demographics
NPI:1437935608
Name:KING, ANN KATHLEEN (SLP)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:KATHLEEN
Last Name:KING
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:KATHLEEN
Other - Last Name:BREIDING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3960 GRACE DR
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-6416
Mailing Address - Country:US
Mailing Address - Phone:330-607-6013
Mailing Address - Fax:
Practice Address - Street 1:3960 GRACE DR
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-6416
Practice Address - Country:US
Practice Address - Phone:330-607-6013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH07483235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist