Provider Demographics
NPI:1467932293
Name:COBB, ANITA (OBHP)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:COBB
Suffix:
Gender:F
Credentials:OBHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 E WASHINGTON ST STE 600
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-2692
Mailing Address - Country:US
Mailing Address - Phone:317-494-0506
Mailing Address - Fax:317-372-8714
Practice Address - Street 1:603 E WASHINGTON ST STE 600
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-2692
Practice Address - Country:US
Practice Address - Phone:317-494-0506
Practice Address - Fax:317-372-8714
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health