Provider Demographics
NPI:1316573587
Name:KNUDTSON, ANNE JEANNINE (MHA)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:JEANNINE
Last Name:KNUDTSON
Suffix:
Gender:F
Credentials:MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 N FRANKLIN ST STE 500
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1169
Mailing Address - Country:US
Mailing Address - Phone:720-506-1229
Mailing Address - Fax:
Practice Address - Street 1:1830 N FRANKLIN ST STE 500
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218
Practice Address - Country:US
Practice Address - Phone:720-506-1229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst