Provider Demographics
NPI:1922265636
Name:AYYAGARI, ANNAPOORNA (DSW, LCSW)
Entity Type:Individual
Prefix:DR
First Name:ANNAPOORNA
Middle Name:
Last Name:AYYAGARI
Suffix:
Gender:F
Credentials:DSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2784 BARTLETT BLVD
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-4530
Mailing Address - Country:US
Mailing Address - Phone:856-630-1592
Mailing Address - Fax:
Practice Address - Street 1:2784 BARTLETT BLVD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-4530
Practice Address - Country:US
Practice Address - Phone:856-630-1592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000062811041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical