Provider Demographics
NPI:1700774312
Name:TRAMMELL, ANN BODEN (LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:BODEN
Last Name:TRAMMELL
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12509 OUTLOOK AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-9446
Mailing Address - Country:US
Mailing Address - Phone:972-897-6894
Mailing Address - Fax:
Practice Address - Street 1:8240 MID CITIES BLVD
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-4711
Practice Address - Country:US
Practice Address - Phone:972-897-6894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99272101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional