Fedotova, Anna Vladimirovna

Fedotova, Anna Vladimirovna is an individual health care provider with primary practice located at 2050 A Second Street Se , Kirtland Afb NM 87117-5546. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Cognitive & Behavioral. Behavioral Health & Social Service Providers / Cognitive & Behavioral is her primary health care specialty. Fedotova, Anna Vladimirovna can be contacted via phone (505) 846-3305.

Contact Information

Primary practice address
2050 A Second Street Se Kirtland Afb NM 87117-5546
Phone: (505) 846-3305
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 6933 Ohio
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X

Profile Details

NPI number 1821306424
LBN Legal business name Fedotova, Anna Vladimirovna
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 16th, 2010
Last updated Sep 2nd, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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