Provider Demographics
NPI:1841860848
Name:MOH, ANNA PATRICIA (MS, LCGC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:PATRICIA
Last Name:MOH
Suffix:
Gender:F
Credentials:MS, LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:877 EXECUTIVE CENTER DR W STE 306
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-2460
Mailing Address - Country:US
Mailing Address - Phone:800-975-4819
Mailing Address - Fax:800-930-0961
Practice Address - Street 1:877 EXECUTIVE CENTER DR W STE 306
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-2460
Practice Address - Country:US
Practice Address - Phone:800-975-4819
Practice Address - Fax:800-930-0961
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAGT61177658170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS