Provider Demographics
NPI:1083004600
Name:ANNE NEVALDINE, PHD, INC.
Entity Type:Organization
Organization Name:ANNE NEVALDINE, PHD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEVALDINE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:907-277-7720
Mailing Address - Street 1:711 BARROW ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3632
Mailing Address - Country:US
Mailing Address - Phone:907-277-7720
Mailing Address - Fax:
Practice Address - Street 1:711 BARROW ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3632
Practice Address - Country:US
Practice Address - Phone:907-277-7720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAA0289103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty