Provider Demographics
NPI:1245021716
Name:DAUBACH, ANNA JOLIE
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:JOLIE
Last Name:DAUBACH
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 1:4001 TRACE HOLLOW RUN
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-2550
Mailing Address - Country:US
Mailing Address - Phone:443-397-5491
Mailing Address - Fax:
Practice Address - Street 1:4001 TRACE HOLLOW RUN
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-2550
Practice Address - Country:US
Practice Address - Phone:443-397-5491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst