Healthcare Provider Details

I. General information

NPI: 1982120929
Provider Name (Legal Business Name): ANNA CHAMNESS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2017
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 CLOVERDALE AVE
WINSTON SALEM NC
27103-2301
US

IV. Provider business mailing address

2221 CLOVERDALE AVE
WINSTON SALEM NC
27103-2301
US

V. Phone/Fax

Practice location:
  • Phone: 336-283-2364
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number208
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: