Provider Demographics
NPI:1750921326
Name:LOCK, ANNA (PSYD)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:LOCK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MRS
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:NOGUERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:320 EMERGENCY ROOM DRIVE #7470
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-0001
Mailing Address - Country:US
Mailing Address - Phone:919-966-3658
Mailing Address - Fax:
Practice Address - Street 1:320 EMERGENCY ROOM DRIVE #7470
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-0001
Practice Address - Country:US
Practice Address - Phone:919-966-3658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-13
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5242103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical