Provider Demographics
NPI:1548396690
Name:SIMON, ANNE KRISTIN (MS)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:KRISTIN
Last Name:SIMON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:KRISTIN
Other - Last Name:CURRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:PO BOX 851
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ID
Mailing Address - Zip Code:83501-0851
Mailing Address - Country:US
Mailing Address - Phone:208-746-7022
Mailing Address - Fax:208-746-2886
Practice Address - Street 1:1022 BRYDEN AVE
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-5353
Practice Address - Country:US
Practice Address - Phone:208-746-7022
Practice Address - Fax:208-746-2886
Is Sole Proprietor?:No
Enumeration Date:2007-02-25
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1858231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist