Provider Demographics
NPI:1821533407
Name:KNEAS, ANN V (MSW)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:V
Last Name:KNEAS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3916 OLD COLONY RD
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-3119
Mailing Address - Country:US
Mailing Address - Phone:269-873-1550
Mailing Address - Fax:
Practice Address - Street 1:3916 OLD COLONY RD
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-3119
Practice Address - Country:US
Practice Address - Phone:269-873-1550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010172551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical