Provider Demographics
NPI:1265158737
Name:BUIE, ANNA K
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:K
Last Name:BUIE
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:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-0190
Mailing Address - Country:US
Mailing Address - Phone:417-655-1603
Mailing Address - Fax:
Practice Address - Street 1:115 IVEY ST APT 4
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-3953
Practice Address - Country:US
Practice Address - Phone:417-655-1603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty