Provider Demographics
NPI:1417497272
Name:WOOLLEY, ANNA L (LADC)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:L
Last Name:WOOLLEY
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:FINDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LADC
Mailing Address - Street 1:343 WOODLAKE DR SE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-6242
Mailing Address - Country:US
Mailing Address - Phone:507-535-5748
Mailing Address - Fax:
Practice Address - Street 1:343 WOODLAKE DR SE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-6242
Practice Address - Country:US
Practice Address - Phone:507-535-5748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-27
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN304579101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)