Provider Demographics
NPI:1619009628
Name:ANNEN, LONETTE MARIE (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LONETTE
Middle Name:MARIE
Last Name:ANNEN
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2952 S STATE ROAD 2
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46385-9674
Mailing Address - Country:US
Mailing Address - Phone:219-531-7608
Mailing Address - Fax:219-531-7608
Practice Address - Street 1:2952 S STATE ROAD 2
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46385-9674
Practice Address - Country:US
Practice Address - Phone:219-531-7608
Practice Address - Fax:219-531-7608
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22002071A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist