Provider Demographics
NPI:1881902047
Name:LATSHAW, ANNE MARIE (SPEECH PATHOLOGIST)
Entity type:Individual
Prefix:MRS
First Name:ANNE MARIE
Middle Name:
Last Name:LATSHAW
Suffix:
Gender:F
Credentials:SPEECH PATHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 MEMORIAL PKWY
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-4818
Mailing Address - Country:US
Mailing Address - Phone:315-368-6018
Mailing Address - Fax:
Practice Address - Street 1:2630 REMINGTON RD
Practice Address - Street 2:HUGH R. JONES ELEMENTARY SCHOOL
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501
Practice Address - Country:US
Practice Address - Phone:315-792-2171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015712-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist