Provider Demographics
NPI:1316639842
Name:CHURCHILL, ANNA EMILY
Entity type:Individual
Prefix:MS
First Name:ANNA
Middle Name:EMILY
Last Name:CHURCHILL
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 1:9 BAY STATE RD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-2240
Mailing Address - Country:US
Mailing Address - Phone:617-899-7624
Mailing Address - Fax:
Practice Address - Street 1:9 BAY STATE RD
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-2240
Practice Address - Country:US
Practice Address - Phone:617-899-7624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor