Provider Demographics
NPI:1336799196
Name:SMITH, ANNA MARIE (MSW, RP, RYT500)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSW, RP, RYT500
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:MARIE
Other - Last Name:TRIPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3585 19TH STREET
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521
Mailing Address - Country:US
Mailing Address - Phone:252-717-6525
Mailing Address - Fax:
Practice Address - Street 1:5277 MANHATTAN CIR STE 250
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-8212
Practice Address - Country:US
Practice Address - Phone:252-717-6525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker