Provider Demographics
NPI:1881767713
Name:VOSS, ANNA FREDRICKA
Entity type:Individual
Prefix:MS
First Name:ANNA
Middle Name:FREDRICKA
Last Name:VOSS
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 E PARK AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-1631
Mailing Address - Country:US
Mailing Address - Phone:864-380-6889
Mailing Address - Fax:
Practice Address - Street 1:101 E PARK AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-1631
Practice Address - Country:US
Practice Address - Phone:864-380-6889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5431101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC3333Medicare ID - Type Unspecified
SC301100Medicaid