Provider Demographics
NPI:1144393901
Name:MAUNEY, ANNIE MELISSA (LBSW, LCDC)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:MELISSA
Last Name:MAUNEY
Suffix:
Gender:F
Credentials:LBSW, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:752 COUNTY ROAD 417
Mailing Address - Street 2:
Mailing Address - City:EVANT
Mailing Address - State:TX
Mailing Address - Zip Code:76525-2532
Mailing Address - Country:US
Mailing Address - Phone:254-471-5906
Mailing Address - Fax:866-560-7260
Practice Address - Street 1:752 COUNTY ROAD 417
Practice Address - Street 2:
Practice Address - City:EVANT
Practice Address - State:TX
Practice Address - Zip Code:76525-2532
Practice Address - Country:US
Practice Address - Phone:254-471-5906
Practice Address - Fax:866-560-7260
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34399171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator