Provider Demographics
NPI:1316702855
Name:ANILUS, MARTHE
Entity type:Individual
Prefix:
First Name:MARTHE
Middle Name:
Last Name:ANILUS
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 1:231 BOSTON POST RD UNIT 32
Mailing Address - Street 2:
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333-1653
Mailing Address - Country:US
Mailing Address - Phone:239-785-8889
Mailing Address - Fax:
Practice Address - Street 1:231 BOSTON POST RD UNIT 32
Practice Address - Street 2:
Practice Address - City:EAST LYME
Practice Address - State:CT
Practice Address - Zip Code:06333-1653
Practice Address - Country:US
Practice Address - Phone:239-785-8889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0122381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical