Provider Demographics
NPI:1699476978
Name:DONNELL, ANCHALI SIOBHAN
Entity type:Individual
Prefix:
First Name:ANCHALI
Middle Name:SIOBHAN
Last Name:DONNELL
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 1:5005 MILLER DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-1877
Mailing Address - Country:US
Mailing Address - Phone:919-384-5951
Mailing Address - Fax:
Practice Address - Street 1:6015 FAYETTEVILLE RD STE 116
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6254
Practice Address - Country:US
Practice Address - Phone:919-480-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst