Provider Demographics
NPI:1730354275
Name:BERG, ANNETTE W (MA, CCC-A, F-AAA)
Entity type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:W
Last Name:BERG
Suffix:
Gender:F
Credentials:MA, CCC-A, F-AAA
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:
Other - Last Name:WOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8321 SANGRE DE CRISTO RD STE 202
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-6426
Mailing Address - Country:US
Mailing Address - Phone:303-984-4414
Mailing Address - Fax:303-984-6244
Practice Address - Street 1:155 S MADISON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-3011
Practice Address - Country:US
Practice Address - Phone:303-321-1408
Practice Address - Fax:303-321-1452
Is Sole Proprietor?:No
Enumeration Date:2008-04-25
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO363231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO378691YR4SMedicare PIN