Provider Demographics
NPI:1548518822
Name:GASSES, ANNA REBEKAH (MS)
Entity type:Individual
Prefix:MS
First Name:ANNA
Middle Name:REBEKAH
Last Name:GASSES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 RIVA RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263-6712
Mailing Address - Country:US
Mailing Address - Phone:706-881-7330
Mailing Address - Fax:
Practice Address - Street 1:2959 SHARPSBURG MCCULLUM RD UNIT C
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2299
Practice Address - Country:US
Practice Address - Phone:770-683-0250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-17
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA007861235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist