| Doctor Name: | ANNIE TATE |
| NPI Number: | 1376819771 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, CCC SLP |
| License Number: | 8501 |
| Business Practice Address: | 1260 West County Road E Arden Hills, MN - 55112 |
| Business Phone Number: | 6516390942 |
| Business Fax Number: | 6516391718 |
| Mailing Address: | 561 West 7th Street, ST. PAUL |
| State: | MN |
| Postal Code: | 55102 |
| Phone Number: | 6512254558 |
| Fax Number: | 6512259474 |
| NPI Enumeration Date: | 03/29/2012 |
| NPI Last Update Date: | 03/29/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 8501 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |