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General NPI Number Information
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NPI Number | 1649207341
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Entity Type | Individual
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Provider Name | ANITA M SCHLANK ABPP, LCP, CSOTP
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Gender | Female
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 10/15/2021
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Provider Practice Location Address
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Address Line | 10106 KRAUSE RD STE 205
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City | CHESTERFIELD
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State | VA
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Zip | 23832-6503
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Country | US
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Telephone | 218-349-7837
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Fax | 218-728-4404
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Provider Business Mailing Address
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Address Line | 9714 DRY CREEK RD
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City | CHESTERFIELD
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State | VA
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Zip | 23832-1935
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Country | US
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Telephone | 218-349-7837
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810003915
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License Number State | VA
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