Provider Demographics
NPI:1396083176
Name:ABELL, ANNA HEIBERGER (PHD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:HEIBERGER
Last Name:ABELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27172 WOODWARD AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-0963
Mailing Address - Country:US
Mailing Address - Phone:248-546-0407
Mailing Address - Fax:
Practice Address - Street 1:27172 WOODWARD AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-0963
Practice Address - Country:US
Practice Address - Phone:248-546-0407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301010047103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical