Provider Demographics
NPI:1679843809
Name:WAY, ANNE MARIE (MA)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:MARIE
Last Name:WAY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5252 WESTCHESTER ST STE 115
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-4100
Mailing Address - Country:US
Mailing Address - Phone:281-771-7311
Mailing Address - Fax:
Practice Address - Street 1:5252 WESTCHESTER ST STE 115
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-4100
Practice Address - Country:US
Practice Address - Phone:281-771-7311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-04
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2341106H00000X
TX9349101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist