Provider Demographics
NPI:1932210119
Name:BADEN, ANNE DAVISON (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:DAVISON
Last Name:BADEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10101 TOUCHWOOD PL
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-6114
Mailing Address - Country:US
Mailing Address - Phone:919-810-8028
Mailing Address - Fax:919-562-7401
Practice Address - Street 1:2001 S MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-1649
Practice Address - Country:US
Practice Address - Phone:919-810-8028
Practice Address - Fax:919-562-7401
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2739103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6000740Medicaid
NC6000740Medicaid