Provider Demographics
NPI:1639335904
Name:ANNABLE, ELIZABETH BREESE ANDERSON (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:BREESE ANDERSON
Last Name:ANNABLE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:BREESE
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:29 RAVENSCROFT DR STE 209
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-3651
Mailing Address - Country:US
Mailing Address - Phone:828-989-6141
Mailing Address - Fax:828-707-9465
Practice Address - Street 1:29 RAVENSCROFT DR STE 209
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-3651
Practice Address - Country:US
Practice Address - Phone:828-989-6141
Practice Address - Fax:828-707-9465
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4381103TC0700X
OR1931103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist