Provider Demographics
NPI:1952068629
Name:HARGER, ANNE JEANNETTE
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:JEANNETTE
Last Name:HARGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 S BRIDGEWAY PL STE 280
Mailing Address - Street 2:OPTIONAL
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616
Mailing Address - Country:US
Mailing Address - Phone:208-412-7740
Mailing Address - Fax:208-853-1318
Practice Address - Street 1:1025 S BRIDGEWAY PL STE 280
Practice Address - Street 2:OPTIONAL
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616
Practice Address - Country:US
Practice Address - Phone:208-412-7740
Practice Address - Fax:208-853-1318
Is Sole Proprietor?:No
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-41369101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor