Healthcare Provider Details
I. General information
NPI: 1457783615
Provider Name (Legal Business Name): ANASTASIA NICOLE FINCH PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/30/2013
Last Update Date: 08/07/2023
Certification Date: 08/07/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1540 SUNDAY DR STE 200
RALEIGH NC
27607-6000
US
IV. Provider business mailing address
3020 BARRYMORE ST UNIT 106
RALEIGH NC
27603-3377
US
V. Phone/Fax
- Phone: 919-384-9682
- Fax:
- Phone: 386-506-9756
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103G00000X |
| Taxonomy | Clinical Neuropsychologist |
| License Number | 5622 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: