Provider Demographics
NPI:1952170961
Name:FRATZKE, ANNIE (AUD CCC-A)
Entity Type:Individual
Prefix:DR
First Name:ANNIE
Middle Name:
Last Name:FRATZKE
Suffix:
Gender:F
Credentials:AUD CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2485 ORCHARD CIRCLE DR APT 12
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-9614
Mailing Address - Country:US
Mailing Address - Phone:216-338-5438
Mailing Address - Fax:
Practice Address - Street 1:1909 N MITCHELL ST
Practice Address - Street 2:
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-1108
Practice Address - Country:US
Practice Address - Phone:231-775-4401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.02475231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist