Provider Demographics
NPI:1013694629
Name:ANKHARTZ, ROSIE (SLP)
Entity Type:Individual
Prefix:MRS
First Name:ROSIE
Middle Name:
Last Name:ANKHARTZ
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 BRACKETT ST UNIT 412
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-4016
Mailing Address - Country:US
Mailing Address - Phone:516-232-4420
Mailing Address - Fax:
Practice Address - Street 1:1601 CONGRESS ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-2102
Practice Address - Country:US
Practice Address - Phone:207-774-5710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-05
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP4087235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist