Provider Demographics
NPI:1477217602
Name:YORK, ANNIE M (SLP)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:M
Last Name:YORK
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2231 PALO DURO DR
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-7212
Mailing Address - Country:US
Mailing Address - Phone:612-414-1953
Mailing Address - Fax:
Practice Address - Street 1:2231 PALO DURO DR
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-7212
Practice Address - Country:US
Practice Address - Phone:612-414-1953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115907235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist