Provider Demographics
NPI:1043692833
Name:DEVANEY, ASENATH ANNE (PHD)
Entity type:Individual
Prefix:DR
First Name:ASENATH
Middle Name:ANNE
Last Name:DEVANEY
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 1:1003 12TH ST
Mailing Address - Street 2:
Mailing Address - City:BUTNER
Mailing Address - State:NC
Mailing Address - Zip Code:27509-1626
Mailing Address - Country:US
Mailing Address - Phone:919-575-7097
Mailing Address - Fax:919-575-7895
Practice Address - Street 1:1003 12TH ST
Practice Address - Street 2:
Practice Address - City:BUTNER
Practice Address - State:NC
Practice Address - Zip Code:27509-1626
Practice Address - Country:US
Practice Address - Phone:919-575-7097
Practice Address - Fax:919-575-7895
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-29
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4447103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist