Provider Demographics
NPI:1215367297
Name:HOWARD, ANITA (CADC I IN TRAINING)
Entity Type:Individual
Prefix:MS
First Name:ANITA
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:CADC I IN TRAINING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 JOSSIE CIR
Mailing Address - Street 2:
Mailing Address - City:COPPERAS COVE
Mailing Address - State:TX
Mailing Address - Zip Code:76522-3309
Mailing Address - Country:US
Mailing Address - Phone:254-290-5040
Mailing Address - Fax:
Practice Address - Street 1:263 W EXCHANGE ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-6142
Practice Address - Country:US
Practice Address - Phone:503-837-3267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-12
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBACB758592106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician