Provider Demographics
NPI:1902402290
Name:CLARK, ANNA SKYE (MS)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:SKYE
Last Name:CLARK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:ANNA
Other - Middle Name:SKYE
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:129 HAVEN ST STE B
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-7800
Mailing Address - Country:US
Mailing Address - Phone:615-266-3899
Mailing Address - Fax:
Practice Address - Street 1:129 HAVEN ST STE B
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-7800
Practice Address - Country:US
Practice Address - Phone:615-266-3899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional