Rae Anne M Roggow, M.S. CCC/SLP

Individual provider Active NPI Speech-Language Pathologist · Sanborn, NY

NPI 1235413402 · NPPES record last updated Oct 5, 2011

Key facts

NPI
1235413402
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
015589 (NY)
Practice address
2292 Saunders Settlement Rd
Sanborn, NY 14132-9521
Phone
(716) 215-3150
NPI assigned
Oct 5, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
015589NYMDClinical Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 015589 NY Yes

Addresses

Primary practice location

2292 Saunders Settlement Rd
Sanborn, NY 14132-9521

Mailing address

3846 Fritz Rd
North Tonawanda, NY 14120-1393
Phone (716) 692-1737

Other providers in Sanborn, NY

All providers in Sanborn, NY · Speech-Language Pathologist in New York

Sources for this page

Verify at the official NPI Registry.