Individual
MRS. ANNE CARLISLE KIDD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH BCPP
Contact information
Practice address
1902 BRAEBURN DR, SALEM, VA 24153-7304
(540) 772-2835
Mailing address
1624 SUNBERRY CIR, ROANOKE, VA 24018-7689
(540) 989-7319
Taxonomy
Speciality
Code
Description
License number
State
1835P1300X
Psychiatric Pharmacist
Primary
0202007158
VA
Other
Enumeration date
11/15/2006
Last updated
07/08/2007
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