Provider Demographics
NPI:1750062279
Name:ALLEN, ANNA-MARIE HOLLY
Entity type:Individual
Prefix:
First Name:ANNA-MARIE
Middle Name:HOLLY
Last Name:ALLEN
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:GREAT STRIDES REHABILITATION
Mailing Address - Street 2:12276 SAN JOSE BLVD, STE. 508
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223
Mailing Address - Country:US
Mailing Address - Phone:904-886-3228
Mailing Address - Fax:904-485-8876
Practice Address - Street 1:GREAT STRIDES REHABILITATION
Practice Address - Street 2:12276 SAN JOSE BLVD, STE. 508
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223
Practice Address - Country:US
Practice Address - Phone:904-886-3228
Practice Address - Fax:904-485-8876
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician