Provider Demographics
NPI:1285303347
Name:ILONZE, ANITA SOMTO
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:SOMTO
Last Name:ILONZE
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 1:2002 PEACHTREE TOWN LN
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-9657
Mailing Address - Country:US
Mailing Address - Phone:919-672-4799
Mailing Address - Fax:
Practice Address - Street 1:3000 HIGHWOODS BLVD STE 310
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-1029
Practice Address - Country:US
Practice Address - Phone:919-714-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical