Provider Demographics
NPI:1871752402
Name:GANTT, ANN L (PHD, MSW, LSW)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:L
Last Name:GANTT
Suffix:
Gender:F
Credentials:PHD, MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 E STRAWBERRY ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-4466
Mailing Address - Country:US
Mailing Address - Phone:717-394-3359
Mailing Address - Fax:
Practice Address - Street 1:537 E STRAWBERRY ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-4466
Practice Address - Country:US
Practice Address - Phone:717-394-3359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW006441L104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker