Provider Demographics
NPI:1982825899
Name:WASSERMAN, AVIVA ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:AVIVA
Middle Name:ANN
Last Name:WASSERMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4620 TARA DRIVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-4208
Mailing Address - Country:US
Mailing Address - Phone:615-665-2623
Mailing Address - Fax:
Practice Address - Street 1:6544 MURRAY LANE
Practice Address - Street 2:THE DIAGNOSTIC CENTER AT CURREY INGRAM ACADEMY
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027
Practice Address - Country:US
Practice Address - Phone:615-507-3171
Practice Address - Fax:615-507-3179
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000001396103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical