Healthcare Provider Details

I. General information

NPI: 1700131653
Provider Name (Legal Business Name): ANNA N CRANE PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2012
Last Update Date: 01/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N LYNNHAVEN RD STE 201
VIRGINIA BEACH VA
23452
US

IV. Provider business mailing address

101 N LYNNHAVEN RD STE 201
VIRGINIA BEACH VA
23452-7523
US

V. Phone/Fax

Practice location:
  • Phone: 757-932-2632
  • Fax: 757-461-4826
Mailing address:
  • Phone: 757-932-2632
  • Fax: 757-461-4826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810004428
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: