Provider Information for 1568120095
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ANITA ANN WILLOUGHBY LCSW
Sex: Female
NPI: 1568120095
Last Updated: 2025-03-25
Certification Date: 2025-03-25
Certification Date: 2025-03-25
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1568120095 | ||||||||
| Enumeration Date | 2021-12-01 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 4001 COLISEUM DR STE 315 HAMPTON, VA 23666-6257 United States Phone: 757-736-2500 | Fax:757-227-4713 | ||||||||
| Primary Practice Address | 4001 COLISEUM DR STE 315 HAMPTON, VA 23666-6257 United States Phone: 757-736-2500 | Fax:757-227-4713 | ||||||||
| Secondary Practice Address(es) | 2302 LENORA LN | ||||||||
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