Healthcare Provider Details

I. General information

NPI: 1720830854
Provider Name (Legal Business Name): ANNIKA MARIE KANNEL SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNIKA MARIE KORNMANN SLP

II. Dates (important events)

Enumeration Date: 04/02/2024
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 E WOODLAND AVE
BARRON WI
54812-1765
US

IV. Provider business mailing address

PO BOX 860912
MINNEAPOLIS MN
55486-0912
US

V. Phone/Fax

Practice location:
  • Phone: 715-537-3186
  • Fax:
Mailing address:
  • Phone: 715-838-5222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number6599
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7041-154
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: