Provider Demographics
NPI:1649450792
Name:HASTINGS, ANN
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:
Last Name:HASTINGS
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 1:2701 W MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-4955
Mailing Address - Country:US
Mailing Address - Phone:623-445-7401
Mailing Address - Fax:623-445-7480
Practice Address - Street 1:2701 W MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-4955
Practice Address - Country:US
Practice Address - Phone:623-445-7401
Practice Address - Fax:623-445-7480
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool