Provider Demographics
NPI:1467751461
Name:FREDMAN, ANNA HUTT (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:HUTT
Last Name:FREDMAN
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 1:9 YAAR LAHAV
Mailing Address - Street 2:UNIT 1
Mailing Address - City:TEL MOND
Mailing Address - State:ZZ - FOREIGN COUNTRIES
Mailing Address - Zip Code:4065002
Mailing Address - Country:IL
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:TEL MOND
Practice Address - Street 2:
Practice Address - City:TEL MOND
Practice Address - State:ZZ - FOREIGN COUNTRIES
Practice Address - Zip Code:4065002
Practice Address - Country:IL
Practice Address - Phone:216-952-9785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-16
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.10421235Z00000X
OHCOND.2011148.SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist