Provider Demographics
NPI:1689249260
Name:PEARSON, ANNA PRISCILLA (MA, CF-SLP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:PRISCILLA
Last Name:PEARSON
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 MEADOW GLEN CV APT 112
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-1798
Mailing Address - Country:US
Mailing Address - Phone:407-741-3321
Mailing Address - Fax:
Practice Address - Street 1:861 W MORSE BLVD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-3765
Practice Address - Country:US
Practice Address - Phone:407-637-2277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-25
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ10052235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist