Provider Demographics
NPI:1033511423
Name:LABOE, ANNA
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:LABOE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 EBENEZER RD
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-2339
Mailing Address - Country:US
Mailing Address - Phone:803-817-7837
Mailing Address - Fax:803-324-4644
Practice Address - Street 1:1450 EBENEZER RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2339
Practice Address - Country:US
Practice Address - Phone:803-817-7837
Practice Address - Fax:803-324-4644
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
SC6979106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist