Provider Demographics
NPI:1669876090
Name:BABCOCK, ANNEMARIE (QMHA)
Entity type:Individual
Prefix:
First Name:ANNEMARIE
Middle Name:
Last Name:BABCOCK
Suffix:
Gender:F
Credentials:QMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3203 VANDENBERG RD
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97603-3778
Mailing Address - Country:US
Mailing Address - Phone:541-880-5500
Mailing Address - Fax:541-880-5513
Practice Address - Street 1:3203 VANDENBERG RD
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97603-3778
Practice Address - Country:US
Practice Address - Phone:541-880-5500
Practice Address - Fax:541-880-5513
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-14
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker