Provider Demographics
NPI:1528380631
Name:SOSA, ANNA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:SOSA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 W PINE KNOLL DR
Mailing Address - Street 2:BLDG. 66, RM. 302
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86011-0001
Mailing Address - Country:US
Mailing Address - Phone:928-523-3845
Mailing Address - Fax:
Practice Address - Street 1:208 W PINE KNOLL DR
Practice Address - Street 2:BLDG. 66, RM. 302
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86011-0001
Practice Address - Country:US
Practice Address - Phone:928-523-3845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP6527235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist