Provider Demographics
NPI:1528439791
Name:PRESBERG, ANN MARIE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:PRESBERG
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12508 ARNSLEY COURT
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171
Mailing Address - Country:US
Mailing Address - Phone:703-901-7277
Mailing Address - Fax:703-373-8785
Practice Address - Street 1:12508 ARNSLEY CT
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-2538
Practice Address - Country:US
Practice Address - Phone:703-901-7277
Practice Address - Fax:703-373-8785
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-14
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202003410235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist