Provider Demographics
NPI:1093999765
Name:MUIR, ANNE HENDRICK (LMFT, QMHP)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:HENDRICK
Last Name:MUIR
Suffix:
Gender:F
Credentials:LMFT, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20350 ENATI CT
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-2742
Mailing Address - Country:US
Mailing Address - Phone:541-550-0567
Mailing Address - Fax:541-388-0479
Practice Address - Street 1:390 SW COLUMBIA ST
Practice Address - Street 2:SUITE 210
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3227
Practice Address - Country:US
Practice Address - Phone:541-550-0567
Practice Address - Fax:541-388-0479
Is Sole Proprietor?:No
Enumeration Date:2007-12-18
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT0216101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health