Provider Demographics
NPI:1336701994
Name:YARBROUGH POWERS, ANNA ELYSE THAMES (MS)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:ELYSE THAMES
Last Name:YARBROUGH POWERS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4237 SALISBURY RD STE 302
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-0908
Mailing Address - Country:US
Mailing Address - Phone:904-217-5538
Mailing Address - Fax:
Practice Address - Street 1:4237 SALISBURY RD STE 302
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-0908
Practice Address - Country:US
Practice Address - Phone:904-217-5538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT4238106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist