Provider Demographics
NPI:1689820235
Name:ANNE L MAULDIN, PH.D., PA
Entity Type:Organization
Organization Name:ANNE L MAULDIN, PH.D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MAULDIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:252-215-0046
Mailing Address - Street 1:704 CROMWELL DR
Mailing Address - Street 2:STE B
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5894
Mailing Address - Country:US
Mailing Address - Phone:252-215-0046
Mailing Address - Fax:252-215-0044
Practice Address - Street 1:704 CROMWELL DR STE B
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5894
Practice Address - Country:US
Practice Address - Phone:252-215-0046
Practice Address - Fax:252-215-0044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2854251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health