Provider Demographics
NPI:1477807295
Name:SPRAGG, ANNELISE (EDS)
Entity Type:Individual
Prefix:MRS
First Name:ANNELISE
Middle Name:
Last Name:SPRAGG
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 M AVE.
Mailing Address - Street 2:ANACORTES SCHOOL DISTRICT
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-3728
Mailing Address - Country:US
Mailing Address - Phone:360-503-1512
Mailing Address - Fax:
Practice Address - Street 1:2200 M AVE
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-3728
Practice Address - Country:US
Practice Address - Phone:360-503-1512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-31
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA487974H103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool