Provider Demographics
NPI:1366892366
Name:CLAVIN, ANNA
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:CLAVIN
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 1:2 2ND AVE S STE 140
Mailing Address - Street 2:
Mailing Address - City:SAUK RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:56379-1457
Mailing Address - Country:US
Mailing Address - Phone:320-406-1600
Mailing Address - Fax:320-297-4720
Practice Address - Street 1:2 2ND AVE S STE 140
Practice Address - Street 2:
Practice Address - City:SAUK RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:56379-1457
Practice Address - Country:US
Practice Address - Phone:320-297-4720
Practice Address - Fax:320-297-4724
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2926106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist