Provider Demographics
NPI:1720312135
Name:VOLPE-BERGHAUS, ANNA TERESA (MA CC/SLP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:TERESA
Last Name:VOLPE-BERGHAUS
Suffix:
Gender:F
Credentials:MA CC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5325 STATE HIGHWAY 37
Mailing Address - Street 2:
Mailing Address - City:OGDENSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:13669-5252
Mailing Address - Country:US
Mailing Address - Phone:315-393-0257
Mailing Address - Fax:
Practice Address - Street 1:7229 STATE HIGHWAY 56
Practice Address - Street 2:BOCES BEGINNING YEARS
Practice Address - City:NORWOOD
Practice Address - State:NY
Practice Address - Zip Code:13668
Practice Address - Country:US
Practice Address - Phone:315-353-6168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004410-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist