Provider Demographics
NPI:1538908298
Name:FLITNER, ANNA (PHD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:FLITNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 AVENUE A
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:WY
Mailing Address - Zip Code:82435-2501
Mailing Address - Country:US
Mailing Address - Phone:605-280-7683
Mailing Address - Fax:
Practice Address - Street 1:535 AVENUE A
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:WY
Practice Address - Zip Code:82435-2501
Practice Address - Country:US
Practice Address - Phone:307-213-9252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY857103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical