Provider Demographics
NPI:1538507504
Name:REIK, ANNA ELIZABETH
Entity Type:Individual
Prefix:MISS
First Name:ANNA
Middle Name:ELIZABETH
Last Name:REIK
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 1:2454 FOX BRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:LAKE SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63367-2511
Mailing Address - Country:US
Mailing Address - Phone:217-260-5613
Mailing Address - Fax:
Practice Address - Street 1:4545 CENTRAL SCHOOL RD
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63304-7113
Practice Address - Country:US
Practice Address - Phone:636-851-4067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012016504235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist