Provider Demographics
NPI:1679119614
Name:WILLOUGHBY, ANYA (LVN, DOULA)
Entity Type:Individual
Prefix:MS
First Name:ANYA
Middle Name:
Last Name:WILLOUGHBY
Suffix:
Gender:F
Credentials:LVN, DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3346 WENTWORTH ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-6317
Mailing Address - Country:US
Mailing Address - Phone:832-688-3537
Mailing Address - Fax:
Practice Address - Street 1:3346 WENTWORTH ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-6317
Practice Address - Country:US
Practice Address - Phone:832-688-3537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula