Provider Demographics
NPI:1740849173
Name:DIAKUN, ANNA ELIZABETH
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:ELIZABETH
Last Name:DIAKUN
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 1:101 MISTY WOODS CIR APT B
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-2486
Mailing Address - Country:US
Mailing Address - Phone:980-253-1005
Mailing Address - Fax:
Practice Address - Street 1:3000 HIGHWOODS BLVD STE 310
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-1029
Practice Address - Country:US
Practice Address - Phone:980-253-1005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0136291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical