Provider Demographics
NPI:1578103875
Name:DAVIS-POPE, ANNA LEE
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:LEE
Last Name:DAVIS-POPE
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 1:142 EAGLE BEND RD
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-9341
Mailing Address - Country:US
Mailing Address - Phone:334-655-0673
Mailing Address - Fax:
Practice Address - Street 1:142 EAGLE BEND RD
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-9341
Practice Address - Country:US
Practice Address - Phone:334-655-0673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-14
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician