Provider Demographics
NPI:1780163881
Name:MINNIX, ANN BARNHART
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:BARNHART
Last Name:MINNIX
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 1:290 S MAIN ST FL 2
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:VA
Mailing Address - Zip Code:24151-1709
Mailing Address - Country:US
Mailing Address - Phone:540-483-0312
Mailing Address - Fax:540-483-0343
Practice Address - Street 1:290 S MAIN ST FL 2
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:VA
Practice Address - Zip Code:24151-1709
Practice Address - Country:US
Practice Address - Phone:540-483-0312
Practice Address - Fax:540-483-0343
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040047901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical