Provider Demographics
NPI:1376376525
Name:ROBERSON, ANNAPHENE ELIZABETH
Entity type:Individual
Prefix:MISS
First Name:ANNAPHENE
Middle Name:ELIZABETH
Last Name:ROBERSON
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 1:31 VOSE AVE UNIT 366
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-6402
Mailing Address - Country:US
Mailing Address - Phone:862-439-6594
Mailing Address - Fax:
Practice Address - Street 1:31 VOSE AVE UNIT 366
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-6402
Practice Address - Country:US
Practice Address - Phone:862-439-6594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC063415001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical