Healthcare Provider Details

I. General information

NPI: 1760312995
Provider Name (Legal Business Name): ANNA ACE
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N CHURCH ST
MONROE NC
28112-4804
US

IV. Provider business mailing address

400 N CHURCH ST
MONROE NC
28112-4804
US

V. Phone/Fax

Practice location:
  • Phone: 704-296-9898
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number30001625
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: