Provider Demographics
NPI:1104578665
Name:SPEIGHT, ANABELLA MARIA
Entity type:Individual
Prefix:
First Name:ANABELLA
Middle Name:MARIA
Last Name:SPEIGHT
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 1:2811 CANTABRIAN DR APT B
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-3526
Mailing Address - Country:US
Mailing Address - Phone:737-900-7458
Mailing Address - Fax:
Practice Address - Street 1:6104 OLD FREDERICKSBURG RD # 90851
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-1216
Practice Address - Country:US
Practice Address - Phone:512-651-4667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty