Provider Demographics
NPI:1144417890
Name:GREGORY, ANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:
Last Name:GREGORY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 EMMET ST S
Mailing Address - Street 2:ROOM 150
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-2424
Mailing Address - Country:US
Mailing Address - Phone:434-924-7034
Mailing Address - Fax:434-924-1433
Practice Address - Street 1:405 EMMET ST S
Practice Address - Street 2:ROOM 150
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-2424
Practice Address - Country:US
Practice Address - Phone:434-924-7034
Practice Address - Fax:434-924-1433
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003852103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical