Provider Information for 1952349011
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
Ms. ANNETTE B. CHURCH LPC, LISAC
Sex: Female
NPI: 1952349011
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1952349011 | ||||||||||||
| Enumeration Date | 2006-06-02 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 642 DAMERON DR PRESCOTT, AZ 86301-2411 United States Phone: 928-445-5211 | Fax:928-776-0963 | ||||||||||||
| Primary Practice Address | 642 DAMERON DR PRESCOTT, AZ 86301-2411 United States Phone: 928-445-5211 | Fax:928-776-0963 | ||||||||||||
| Secondary Practice Address(es) | |||||||||||||
| Health Information Exchange |
| ||||||||||||
| Other Identifiers |
| ||||||||||||
| Taxonomy |
|