Basic Information
| Provider Information | |||||||||
| NPI: | 1932822608 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANNE M WINDBERG | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2563 CATHEVEY LN | ||||||||
| Address2: | |||||||||
| City: | MUSKEGON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494444195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2313273564 | ||||||||
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| Address1: | 2563 CATHEVEY LN | ||||||||
| Address2: | |||||||||
| City: | MUSKEGON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494444195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2313273564 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/19/2022 | ||||||||
| LastUpdateDate: | 09/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | WINDBERG | ||||||||
| AuthorizedOfficialFirstName: | ANNE | ||||||||
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| AuthorizedOfficialTitleorPosition: | MASTER'S LIMITED PSYCHOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 2313273564 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MA MLP | ||||||||
| NPICertificationDate: | 09/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.