Anna Marie Peterson, MS CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

528578 Issued in MN

Practice address

3815 W Broadway Ave
Robbinsdale, MN 55422-2207

Phone

(651) 767-9416

NPI assigned

Apr 23, 2025

Last updated

Apr 23, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1745366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1023805983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 W BROADWAY AVE",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222207",
            "telephone_number": "651-767-9416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 W BROADWAY AVE",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222207",
            "telephone_number": "651-767-9416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ANNA",
        "middle_name": "MARIE",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-23",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "528578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas W Peltola, MD
• Jennifer J Peoples, MD
• Michelle Marie Perault-Boughton, PT
• Sarah Perlin, RD
• Michael J Peterman, MD
• Bridget Peterson
• Earl Joel Peterson, M.D.
• Marian Peterson
• Shannon Nicole Peterson
• Terri Ann Peterson, OTR, CMLDT

• Speech-Language Pathologist in Robbinsdale, MN
• Providers in Robbinsdale, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.