Individual
DR. ANNA ROSS HERTEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1100 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1944
(800) 691-8387
Mailing address
PO BOX 2429, SMYRNA, TN 37167-1719
(417) 891-4800
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
2003023851
MO
103TC0700X
Clinical Psychologist
Primary
2003023851
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
498311117
—
MO
Enumeration date
10/02/2006
Last updated
05/05/2020
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