Provider Demographics
NPI:1518055995
Name:WILL, ANNE-MARIE M
Entity Type:Individual
Prefix:
First Name:ANNE-MARIE
Middle Name:M
Last Name:WILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNE-MARIE
Other - Middle Name:M
Other - Last Name:BADENHORST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1330 W 26TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-1402
Mailing Address - Country:US
Mailing Address - Phone:814-459-9300
Mailing Address - Fax:814-454-7780
Practice Address - Street 1:1330 W 26TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-1402
Practice Address - Country:US
Practice Address - Phone:814-459-9300
Practice Address - Fax:814-454-7780
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW123947104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
251317492OtherSAFE HARBOR BEAHVIORAL HE