Provider Demographics
NPI:1053109504
Name:ANNA RESNICK
Entity type:Organization
Organization Name:ANNA RESNICK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:RESNICK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:203-887-6040
Mailing Address - Street 1:32 BUCKHORN GAP RD
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-0230
Mailing Address - Country:US
Mailing Address - Phone:203-887-6040
Mailing Address - Fax:828-633-0572
Practice Address - Street 1:32 BUCKHORN GAP RD
Practice Address - Street 2:
Practice Address - City:CANDLER
Practice Address - State:NC
Practice Address - Zip Code:28715-0230
Practice Address - Country:US
Practice Address - Phone:203-887-6040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health