Church, Annette B.

Church, Annette B. is an individual health care provider with primary practice located at 642 Dameron Dr , Prescott AZ 86301-2411. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Church, Annette B. can be contacted via phone (928) 445-5211.

Contact Information

Primary practice address
642 Dameron Dr Prescott AZ 86301-2411
Phone: (928) 445-5211
Fax: (928) 776-0963
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LISAC-10423 Arizona
Behavioral Health & Social Service Providers / Professional 101YP2500X LPC-10149 Arizona

Profile Details

NPI number 1952349011
LBN Legal business name Church, Annette B.
Credentials LPC, LISAC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952349011 NPPES
Arizona Other 590027 AHCCCS #

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