Provider Demographics
NPI:1215045158
Name:TROWBRIDGE, ANITA FAY (PSYD)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:FAY
Last Name:TROWBRIDGE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 MOUNTAIN CREEK RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-4501
Mailing Address - Country:US
Mailing Address - Phone:423-870-0036
Mailing Address - Fax:423-870-0706
Practice Address - Street 1:901 MOUNTAIN CREEK RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405-4501
Practice Address - Country:US
Practice Address - Phone:423-870-0036
Practice Address - Fax:423-870-0706
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP2260103TC0700X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
3981306Medicare ID - Type Unspecified