Provider Demographics
NPI:1508626987
Name:ANTHONY, TEMILAYO RENEE
Entity Type:Individual
Prefix:
First Name:TEMILAYO
Middle Name:RENEE
Last Name:ANTHONY
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 1:104 BUCHANAN HALL
Mailing Address - Street 2:GRADUATE SOCIAL WORK
Mailing Address - City:NORMAL
Mailing Address - State:AL
Mailing Address - Zip Code:35762
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:104 BUCHANAN HALL
Practice Address - Street 2:GRADUATE SOCIAL WORK
Practice Address - City:NORMAL
Practice Address - State:AL
Practice Address - Zip Code:35762
Practice Address - Country:US
Practice Address - Phone:917-391-3740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program