Provider Demographics
NPI:1760267504
Name:HAIDLE, ANNA BROOKS PARTLOW
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:BROOKS PARTLOW
Last Name:HAIDLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:BROOKS
Other - Last Name:PARTLOW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC-MHSP
Mailing Address - Street 1:510 E IRIS DR STE B
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-3110
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:510 E IRIS DR STE B
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-3110
Practice Address - Country:US
Practice Address - Phone:615-512-7268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000004625101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health