Provider Demographics
NPI:1780242339
Name:RUFFALO, ANNALEE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANNALEE
Middle Name:
Last Name:RUFFALO
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 WRIGHT RD
Mailing Address - Street 2:
Mailing Address - City:KINGS MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28086-8943
Mailing Address - Country:US
Mailing Address - Phone:570-616-5433
Mailing Address - Fax:
Practice Address - Street 1:341 WRIGHT RD
Practice Address - Street 2:
Practice Address - City:KINGS MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28086-8943
Practice Address - Country:US
Practice Address - Phone:570-616-5433
Practice Address - Fax:704-710-8085
Is Sole Proprietor?:No
Enumeration Date:2019-05-30
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13568235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist