Healthcare Provider Details

I. General information

NPI: 1316951924
Provider Name (Legal Business Name): ANITA LOUISE ROYER LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

792 COLLEGE PKWY SUITE 205
COLCHESTER VT
05446-3052
US

IV. Provider business mailing address

7981 SPEAR ST
CHARLOTTE VT
05445-8219
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-7597
  • Fax:
Mailing address:
  • Phone: 802-425-3283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number0890000338
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: