Provider Demographics
NPI:1649207341
Name:SCHLANK, ANITA M (ABPP, LCP, CSOTP)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:M
Last Name:SCHLANK
Suffix:
Gender:F
Credentials:ABPP, LCP, CSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9714 DRY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-1935
Mailing Address - Country:US
Mailing Address - Phone:218-349-7837
Mailing Address - Fax:
Practice Address - Street 1:10106 KRAUSE RD STE 205
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-6503
Practice Address - Country:US
Practice Address - Phone:218-349-7837
Practice Address - Fax:218-728-4404
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003915103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical