| Doctor Name: | MRS. MARY ANITA VANNOSKE |
| NPI Number: | 1023325602 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 1706 Wayne Memorial Dr Goldsboro, NC - 275342240 |
| Business Phone Number: | 9197346676 |
| Business Fax Number: | 9197349050 |
| Mailing Address: | 1706 Wayne Memorial Dr, GOLDSBORO |
| State: | NC |
| Postal Code: | 275342240 |
| Phone Number: | 9197346676 |
| Fax Number: | 9197349050 |
| NPI Enumeration Date: | 09/03/2010 |
| NPI Last Update Date: | 09/03/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |