Provider Demographics
NPI:1437488293
Name:GOLETZ, ANNA W
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:W
Last Name:GOLETZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 REBECCA DR
Mailing Address - Street 2:
Mailing Address - City:BURNS
Mailing Address - State:TN
Mailing Address - Zip Code:37029-6038
Mailing Address - Country:US
Mailing Address - Phone:615-838-9634
Mailing Address - Fax:
Practice Address - Street 1:201 UFFELMAN DR STE F
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-2970
Practice Address - Country:US
Practice Address - Phone:931-920-7333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor