Provider Demographics
NPI:1952653917
Name:SPANGLER-BETHUNE, ANNA VINSON (MS)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:VINSON
Last Name:SPANGLER-BETHUNE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:GA
Mailing Address - Zip Code:30206-0004
Mailing Address - Country:US
Mailing Address - Phone:770-584-2924
Mailing Address - Fax:
Practice Address - Street 1:267 HOOD RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:GA
Practice Address - Zip Code:30206-2203
Practice Address - Country:US
Practice Address - Phone:770-584-2924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor