Provider Demographics
NPI:1295191682
Name:KOBOLD, ANNE
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:KOBOLD
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 1:311 W HIGH ST
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46516-2827
Mailing Address - Country:US
Mailing Address - Phone:574-262-3597
Mailing Address - Fax:574-262-3599
Practice Address - Street 1:311 W HIGH ST
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46516-2827
Practice Address - Country:US
Practice Address - Phone:574-262-3597
Practice Address - Fax:574-262-3599
Is Sole Proprietor?:No
Enumeration Date:2016-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33007612A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker