Provider Demographics
NPI:1083737068
Name:SPAHR, ANNE M FORS (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:M FORS
Last Name:SPAHR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ANNE
Other - Middle Name:M
Other - Last Name:FORS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1587 S MOORLAND RD
Mailing Address - Street 2:#107
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-1586
Mailing Address - Country:US
Mailing Address - Phone:262-782-0280
Mailing Address - Fax:
Practice Address - Street 1:5303 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53208-1021
Practice Address - Country:US
Practice Address - Phone:414-445-0997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1923103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39117400Medicaid
MN914666100Medicaid