Provider Demographics
NPI:1841466455
Name:JOCHIMSEN, ANN E (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:E
Last Name:JOCHIMSEN
Suffix:
Gender:F
Credentials: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:W8711 BLACKEN AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:WI
Mailing Address - Zip Code:54451-8944
Mailing Address - Country:US
Mailing Address - Phone:715-748-0876
Mailing Address - Fax:
Practice Address - Street 1:W8711 BLACKEN AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:WI
Practice Address - Zip Code:54451-8944
Practice Address - Country:US
Practice Address - Phone:715-748-0876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-03
Last Update Date:2008-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI869-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42579500Medicaid