Provider Demographics
NPI:1689820730
Name:KNATCAL, ANISHA L (MA, CCC)
Entity Type:Individual
Prefix:
First Name:ANISHA
Middle Name:L
Last Name:KNATCAL
Suffix:
Gender:F
Credentials:MA, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 COUNTY ROAD E W
Mailing Address - Street 2:
Mailing Address - City:ARDEN HILLS
Mailing Address - State:MN
Mailing Address - Zip Code:55112-3700
Mailing Address - Country:US
Mailing Address - Phone:651-639-0942
Mailing Address - Fax:651-639-1718
Practice Address - Street 1:1260 COUNTY ROAD E W
Practice Address - Street 2:
Practice Address - City:ARDEN HILLS
Practice Address - State:MN
Practice Address - Zip Code:55112-3700
Practice Address - Country:US
Practice Address - Phone:651-639-0942
Practice Address - Fax:651-639-1718
Is Sole Proprietor?:No
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8322235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist