Provider Demographics
NPI:1770658106
Name:CLOHESSY, ANNE B (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:B
Last Name:CLOHESSY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3324 ELDER ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-4713
Mailing Address - Country:US
Mailing Address - Phone:208-333-0008
Mailing Address - Fax:208-333-0888
Practice Address - Street 1:3324 ELDER ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-4713
Practice Address - Country:US
Practice Address - Phone:208-333-0008
Practice Address - Fax:208-333-0888
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPSY302103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical