Provider Demographics
NPI:1487196127
Name:THATCHER, ANNIE ELIZABETH
Entity Type:Individual
Prefix:MISS
First Name:ANNIE
Middle Name:ELIZABETH
Last Name:THATCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 MUSSER ST
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78043-2350
Mailing Address - Country:US
Mailing Address - Phone:956-645-7959
Mailing Address - Fax:
Practice Address - Street 1:1702 MUSSER ST
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78043-2350
Practice Address - Country:US
Practice Address - Phone:956-645-7959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-11
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112201235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist